Individual
ELIZABETH DAWN TUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1866 S MOREY RD, LAKE CITY, MI 49651-9190
(231) 908-8888
(833) 989-2153
Mailing address
1866 S MOREY RD, LAKE CITY, MI 49651-9190
(231) 908-8888
(833) 989-2153
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704272712
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704272712
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704272712
LICENSE
MI
Enumeration date
06/29/2018
Last updated
09/28/2022
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