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General NPI Number Information
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NPI Number | 1528770096
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Entity Type | Individual
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Provider Name | MEGAN TUCKER PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/15/2022
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 175 S WILKES BARRE BLVD
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City | WILKES BARRE
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State | PA
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Zip | 18702-5040
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Country | US
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Telephone | 570-208-6281
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Fax | 570-208-6282
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 570-208-6281
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Fax | 570-208-6282
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA064255
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA064255
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License Number State | PA
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