Individual
MR. TUCKER LEE BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
601 BROOKMAN DR EXT, BROOKHAVEN, MS 39601-2371
(601) 823-5275
Mailing address
1522 OLD HIGHWAY 51 NE, BROOKHAVEN, MS 39601-9553
(601) 754-2690
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903771
MS
Other
Enumeration date
02/28/2020
Last updated
01/09/2025
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