Individual
CHARLET TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
16844 127TH AVE, 4D, JAMAICA, NY 11434-3150
(718) 527-7792
Mailing address
16844 127TH AVE, 4D, JAMAICA, NY 11434-3150
(646) 465-2334
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
206288
NY
164W00000X
Licensed Practical Nurse
206288-01
NY
Other
Enumeration date
08/13/2009
Last updated
08/05/2025
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