Individual
JENIFER TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4121 VIA ST, SHREVEPORT, LA 71109-8346
(318) 218-0569
Mailing address
4121 VIA ST, SHREVEPORT, LA 71109-8346
(318) 218-0569
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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