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General NPI Number Information
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NPI Number | 1396483657
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Entity Type | Organization
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Legal Business Name | TUCKER-WALLS GROUP LLC
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 314 SUNNYLAND AVE
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City | PITTSBURGH
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State | PA
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Zip | 15227-1841
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Country | US
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Telephone | 412-770-8732
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Fax | 412-242-4540
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Provider Business Mailing Address
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Address Line | 314 SUNNYLAND AVE
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City | PITTSBURGH
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State | PA
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Zip | 15227-1841
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Country | US
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Telephone | 412-770-8732
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Fax | 412-242-4540
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Authorized Official
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Title or Position | OWNER
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Name | NIKIA SIMONE TUCKER
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Credential | CNRP
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Telephone | 412-770-8732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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