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Individual

LEVI JACOB TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
801 W 8TH ST, COFFEYVILLE, KS 67337-4109
(620) 251-4300
Mailing address
PO BOX 1832, PITTSBURG, KS 66762-1832
(888) 777-9170

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5381178091
KS

Other

Enumeration date
02/29/2024
Last updated
04/24/2024
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