Individual
MR. ROBERT L TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2372 HWY 49 EAST, SUMNER, MS 38957-0250
(662) 375-9310
Mailing address
PO BOX 627, WEBB, MS 38966-0627
(662) 375-9310
(662) 375-9311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R853452
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123085
—
MS
01
—
224548
HEALTH PARTNERS CLAIMS
—
01
—
253408
MEDICARE PART A
MS
Enumeration date
09/07/2006
Last updated
04/12/2013
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