Individual
MRS. LYDIA TUCKER-STICKELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
230 MURLEY DR, MADISON, WI 53718-3308
(608) 242-4605
Mailing address
230 MURLEY DR, MADISON, WI 53718-3308
(608) 242-4605
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38352300
—
WI
Enumeration date
07/29/2006
Last updated
07/09/2007
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