MEDICARE: TAYLOR E TUCKER MSN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	17892	TN

General Provider Information

NPI Number	:	1952736845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR E TUCKER MSN, FNP-C

Provider Business Mailing Address
First Line	:	901 RIVERFRONT PARKWAY
Second Line	:	SUITE 300
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2193
Country	:	US
Telephone Number	:	423-698-8981
Fax Number	:	423-697-7109

Provider Business Practice Location Address
First Line	:	901 RIVERFRONT PARKWAY
Second Line	:	SUITE 300
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2193
Country	:	US
Telephone Number	:	423-698-8981
Fax Number	:	423-697-7109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2013
Last Update Date	:	06/10/2021

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