Individual
EMILY ROSE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1450 SCALP AVE, STE 1000, JOHNSTOWN, PA 15904-3321
(814) 269-5200
(814) 472-7336
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 269-5200
(814) 472-7336
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053843
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007698380001
—
PA
05
—
1007698380002
—
PA
Enumeration date
06/04/2009
Last updated
09/11/2015
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