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Individual

MARY E. TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1101 N 27TH ST, SUITE F, BILLINGS, MT 59101-0101
(406) 325-5555
(406) 325-5556
Mailing address
1101 N 27TH ST, SUITE F, BILLINGS, MT 59101-0101
(406) 325-5555
(406) 325-5555

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
461
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000901703
BLUE CROSS BLUE SHIELD
MT
Enumeration date
08/31/2006
Last updated
03/17/2009
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