Individual
JAMIE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
142 W 5TH ST, COOKEVILLE, TN 38501-1760
(866) 313-5259
(205) 313-5298
Mailing address
PO BOX 938, COOKEVILLE, TN 38503-0938
(866) 313-5259
(205) 313-5298
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
302
TN
Other
Enumeration date
06/15/2005
Last updated
07/09/2007
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