Individual
TERESA D TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
765 FLORENCE RD, SAVANNAH, TN 38372-3451
(731) 925-2300
Mailing address
PO BOX 655, SAVANNAH, TN 38372-0655
(731) 925-2300
(731) 925-3506
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN0000013057
TN
363LG0600X
Gerontology Nurse Practitioner
Primary
13057
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3341539
—
TN
01
—
613360505
DOL FECA
—
01
—
APN0000013057
STATE LICENSE
TN
Enumeration date
11/30/2007
Last updated
12/13/2022
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