Individual
TRISHA THOMAS TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC, FNP-BC
Contact information
Practice address
18580 FORT ST, RIVERVIEW, MI 48193-7442
(734) 479-8800
Mailing address
22619 FOXMOOR DR, NOVI, MI 48374-3729
(248) 345-5224
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704304060
MI
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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