Individual
SHELLI TUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C, MS, BSN
Contact information
Practice address
34279 ASPEN PARK DR, CHESTERFIELD, MI 48047-6105
(586) 243-9120
(586) 610-2722
Mailing address
34279 ASPEN PARK DR, CHESTERFIELD, MI 48047-6105
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AG07220208
MI
363LA2200X
Adult Health Nurse Practitioner
AG05170100
MI
363LG0600X
Gerontology Nurse Practitioner
AG05170100
MI
363LP2300X
Primary Care Nurse Practitioner
AG05170100
MI
Other
Enumeration date
06/03/2017
Last updated
07/28/2022
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