MEDICARE: MRS. DANIELLE TUCKER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	53-77120-051	KS
2	363LF0000X	Family Nurse Practitioner	2014044285	MO

General Provider Information

NPI Number	:	1023409844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE TUCKER NP

Provider Business Mailing Address
First Line	:	2790 CLAY EDWARDS DR STE 650
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-3279
Country	:	US
Telephone Number	:	816-559-6531
Fax Number	:

Provider Business Practice Location Address
First Line	:	8250 N CHURCH RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-1103
Country	:	US
Telephone Number	:	816-459-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2015
Last Update Date	:	03/13/2025

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