Individual
JENNIFER TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(844) 458-2100
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(844) 458-2100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
215241
OK
Other
Enumeration date
10/23/2023
Last updated
10/24/2023
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