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NPI Code Detail

MEDICARE: SHERYL TUCKER

MEDICARE: SHERYL TUCKER
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
1175T00000XPeer SpecialistOH

General Provider Information

NPI Number : 1164375887
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERYL TUCKER
Provider Business Mailing Address
First Line : 109 GROVE ST
Second Line :
City : LODI
State : OH
Zip : 44254-1211
Country : US
Telephone Number : 330-636-0330
Fax Number :
Provider Business Practice Location Address
First Line : 155 MONTROSE WEST AVE
Second Line :
City : COPLEY
State : OH
Zip : 44321-3121
Country : US
Telephone Number : 330-993-4649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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Directions to “ SHERYL TUCKER ” Practice Location

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