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Individual

PAMELA D TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
600 TRENT STREET, PRINCETON, WV 24740
(304) 425-7111
(304) 425-1138
Mailing address
355 BLUEFIELD AVE, BLUEFIELD, WV 24701-2883
(304) 425-7111
(304) 425-1138

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568796027
WV
05
55-6025355
WV
Enumeration date
10/02/2020
Last updated
10/02/2020
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