Individual
TYLENA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3536 N 40TH AVE, OMAHA, NE 68111-2648
(531) 224-6446
Mailing address
3536 N 40TH AVE, OMAHA, NE 68111-2648
(531) 224-6446
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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