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Individual

JAMES ROBERT TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1200 W MAPLE AVE, GENEVA, AL 36340-1642
(334) 684-3655
Mailing address
1200 W MAPLE AVE, GENEVA, AL 36340-1642
(334) 684-3655

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-084210
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051524147
BCBS
AL
05
051554570
AL
01
1-084210
ALABAMA BOARD OF NURSING
AL
05
311783900
FL
Enumeration date
07/28/2006
Last updated
07/09/2007
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