Individual
MRS. MARQUITA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1050 HIGHWAY 98 BYP, COLUMBIA, MS 39429-9190
(601) 522-2095
Mailing address
PO BOX 1258, WAYNESBORO, TN 38485-1258
(931) 253-1110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902535
MS
Other
Enumeration date
08/29/2018
Last updated
06/22/2020
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