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General NPI Number Information
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NPI Number | 1194501742
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Entity Type | Individual
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Provider Name | MAGGIE C TUCKER RN
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Gender | Female
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 200 GENTILLY BLVD STE 1300
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City | CARTERSVILLE
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State | GA
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Zip | 30120-8504
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Country | US
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Telephone | 470-490-6860
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Fax |
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Provider Business Mailing Address
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Address Line | 42 FALCON CV
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City | DALLAS
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State | GA
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Zip | 30132-6622
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Country | US
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Telephone |
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN299681
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN-NP299681
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License Number State | GA
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