Individual
KAITLIN REAGAN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1218 TROTWOOD AVE, COLUMBIA, TN 38401-6406
(931) 380-4114
Mailing address
1218 TROTWOOD AVE, COLUMBIA, TN 38401-6406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TN
Other
Enumeration date
10/30/2012
Last updated
09/27/2013
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