Individual
NANCY P TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
115 HALTON VILLAGE CIRCLE, GREENWAY, SC 29607-6825
(864) 281-9440
(864) 281-9443
Mailing address
115 HALTON VILLAGE CIRCLE, GREENWAY, SC 29607-6825
(864) 281-9440
(864) 281-9443
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
3171
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7844
MEDICARE
SC
05
—
GP4505
—
SC
05
—
SA0369
—
SC
Enumeration date
05/22/2008
Last updated
06/24/2016
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