Individual
JEAN M TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS, MS
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
209.008253
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-008253
LICENSE ADVANCE PRACTICE NURSE
IL
Enumeration date
08/31/2010
Last updated
09/16/2010
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