Individual
KARL TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
250 N OREM BLVD, OREM, UT 84057-6601
(801) 609-2448
(801) 609-2447
Mailing address
822 S 1040 W # 3B, PAYSON, UT 84651-4614
(801) 609-2448
(801) 609-2447
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7327288-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007365
—
UT
Enumeration date
06/18/2018
Last updated
03/23/2023
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