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Individual

JENNIFER TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, RN

Contact information

Practice address
8715 IVYWOOD AVE S, COTTAGE GROVE, MN 55016-4728
(608) 792-3072
Mailing address
8715 IVYWOOD AVE S, COTTAGE GROVE, MN 55016-4728

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1735824
MN

Other

Enumeration date
09/11/2021
Last updated
09/11/2021
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