Individual
ANGELA RENE TUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
77 NEALY AVE, LANGLEY AFB, VA 23665-2040
(757) 764-6732
Mailing address
77 NEALY AVE, LANGLEY AFB, VA 23665-2040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
84331
NE
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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