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General NPI Number Information
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NPI Number | 1881184067
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Entity Type | Individual
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Provider Name | JUDITH LYNN CORRADO TUCKER APRN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 58 CAROTHERS RD
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City | NEWPORT
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State | KY
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Zip | 41071-2416
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Country | US
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Telephone | 513-240-2985
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Fax | 513-938-8180
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Provider Business Mailing Address
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Address Line | 175 REMINGTON DR
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City | BARDSTOWN
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State | KY
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Zip | 40004-2268
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Country | US
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Telephone | 513-240-2985
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Fax | 513-938-8180
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3012260
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License Number State | KY
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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 | APRN.CNP.022476
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License Number State | OH
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