Individual
CANDY TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
315 BRADY MILL RD, ANNA, IL 62906-2306
(618) 833-6343
Mailing address
315 BRADY MILL RD, ANNA, IL 62906-2306
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
041417537
IL
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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