Individual
DAKOTA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, CPNP-PC
Contact information
Practice address
411 TOWN PARK BLVD, EVANS, GA 30809-3487
(706) 854-2500
Mailing address
411 TOWN PARK BLVD, EVANS, GA 30809-3487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
RN258659
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN258659
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003275375A
—
GA
05
—
003275375C
—
GA
05
—
003275375D
—
GA
Enumeration date
08/07/2021
Last updated
10/28/2025
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