Individual
MS. KENYA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6524 OLD NATIONAL HWY STE 203, ATLANTA, GA 30349-4853
(770) 731-1098
(404) 296-1850
Mailing address
42 CARRIAGE OAKS DR # 111, TYRONE, GA 30290-1684
(404) 314-5248
(770) 731-1098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004484
GA
Other
Enumeration date
02/22/2007
Last updated
07/13/2023
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