Individual
MRS. NICHOLE ELIZABETH TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
200 FORBES ST, STE 200, ANNAPOLIS, MD 21401-1538
(410) 263-6363
(410) 263-4086
Mailing address
200 FORBES ST, SUITE 200, ANNAPOLIS, MD 21401-1538
(410) 263-6363
(410) 263-4086
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R191254
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R191254
CRNP RN LICENSE #
MD
Enumeration date
06/22/2012
Last updated
12/11/2014
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