Healthcare Provider Details
I. General information
NPI: 1770721375
Provider Name (Legal Business Name): BARBARA A TUCKER CNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/04/2009
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
770 W HIGH ST SUITE 450
LIMA OH
45801-3990
US
IV. Provider business mailing address
PO BOX 636930
CINCINNATI OH
45263-0001
US
V. Phone/Fax
- Phone: 419-996-5240
- Fax: 419-996-5242
- Phone: 513-981-5123
- Fax: 513-981-5015
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SA2200X |
| Taxonomy | Adult Health Clinical Nurse Specialist |
| License Number | 304386 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: