Individual
SHAVON TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3314 W ORIOLE DR, MILWAUKEE, WI 53209-4101
(414) 210-4110
(414) 446-5836
Mailing address
4025 W KILEY AVE, MILWAUKEE, WI 53209-2238
(414) 322-4595
(414) 446-5836
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
315877
WI
Other
Enumeration date
11/25/2024
Last updated
05/28/2025
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