Individual
MRS. GRACE LEE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3308 W EDGEWOOD DR STE B, JEFFERSON CITY, MO 65109-6891
(573) 893-7848
Mailing address
2408 BOULDER SPRINGS DR, COLUMBIA, MO 65201-8595
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017019305
MO
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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