Healthcare Provider Details

I. General information

NPI: 1285075689
Provider Name (Legal Business Name): CHRISTIE R TUCKER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2013
Last Update Date: 11/14/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N HIGHLAND AVE STE 2A
MURFREESBORO TN
37130-2495
US

IV. Provider business mailing address

PO BOX 681508
FRANKLIN TN
37068-1508
US

V. Phone/Fax

Practice location:
  • Phone: 615-661-7888
  • Fax: 615-661-9001
Mailing address:
  • Phone: 615-661-7888
  • Fax: 615-661-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17795
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: