Individual
KERRI L TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 E IDAHO ST, STE 400, BOISE, ID 83712-6267
(208) 345-5250
(208) 345-2364
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 345-5250
(208) 345-2364
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
NP 807A
ID
Other
Enumeration date
04/17/2007
Last updated
09/18/2012
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