Individual
SHAWNA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
422 3RD STREET, EVANSTON, WY 82930
(307) 789-7040
Mailing address
422 3RD STREET, EVANSTON, WY 82930
(307) 789-7040
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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