Individual
MRS. MORIAH DIANE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
563 HEATHER DR, APT. 3D, DAYTON, OH 45405-1739
(937) 903-0399
Mailing address
563 HEATHER DR, APT. 3D, DAYTON, OH 45405-1739
(937) 903-0399
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
191305
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
026583
OH
Other
Enumeration date
05/15/2013
Last updated
08/13/2020
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