Individual
MRS. JESSICA YVETTE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7497
(601) 815-7490
Mailing address
101 HARTFIELD CT, MADISON, MS 39110-6581
(601) 506-8550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902406
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3187272
—
MS
Enumeration date
12/31/2017
Last updated
08/18/2021
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