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General NPI Number Information
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NPI Number | 1871046144
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Entity Type | Individual
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Provider Name | CHRISTINE TUCKER CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 675 JUSTICE WAY ROOM C0049
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City | INDIANAPOLIS
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State | IN
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Zip | 46203
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Country | US
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Telephone | 877-465-6650
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Fax | 804-294-2775
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Provider Business Mailing Address
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Address Line | 18 OLD GRANDVIEW AVE
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City | DALLAS
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State | PA
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Zip | 18612-1115
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Country | US
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Telephone | 570-479-8797
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Fax | 833-228-5591
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP016436
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP016436
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License Number State | PA
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