Individual
SARAH M TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
102 SHELBY SPEIGHTS DR, PURVIS, MS 39475-4151
(601) 794-8068
(601) 794-5650
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 794-8068
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R861886
MS
363LF0000X
Family Nurse Practitioner
Primary
861886
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02478201
—
MS
05
—
1791199
—
LA
01
—
3437160
AMERICAN ADMIN GROUP
MS
Enumeration date
08/30/2006
Last updated
07/23/2020
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