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Individual

MRS. MARCELLA LOUISE TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
4801 E LINWOOD BLVD, KANSAS CITY, MO 64128-2226
(816) 922-2705
(816) 922-4753
Mailing address
7724 IRWIN RD, RAYTOWN, MO 64138-2569
(816) 737-3052

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
040504
MO

Other

Enumeration date
05/30/2012
Last updated
05/30/2012
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