Individual
RACHAEL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-5432
Mailing address
1531 TENNIS CLUB RD, CHARLESTON, WV 25314-2343
(304) 382-6006
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
148274
WV
390200000X
Student in an Organized Health Care Education/Training Program
91625
WV
Other
Enumeration date
04/06/2022
Last updated
05/02/2024
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