Individual
SHIRLEY RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3098 MOUNT OLIVE RD, MEMPHIS, TN 38108-1849
(901) 649-9582
Mailing address
3098 MOUNT OLIVE RD, MEMPHIS, TN 38108-1849
(901) 649-9582
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
180006429
TN
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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