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General NPI Number Information
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NPI Number | 1053560227
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Entity Type | Individual
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Provider Name | TAMI TUCKER C.F.M.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 1025 CONCORD PKWY N
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City | CONCORD
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State | NC
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Zip | 28027-5923
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Country | US
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Telephone | 704-782-0908
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Fax | 704-786-0469
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Provider Business Mailing Address
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Address Line | 1025 CONCORD PKWY N
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City | CONCORD
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State | NC
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Zip | 28027-5923
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Country | US
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Telephone | 704-782-0908
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Fax | 704-786-0469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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