MEDICARE: MRS. CATHY TUCKER LLPN

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	364SM0705X	Medical-Surgical Clinical Nurse Specialist	181145	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548428865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHY TUCKER LLPN

Provider Business Mailing Address
First Line	:	1653 BEACH AVE
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-1607
Country	:	US
Telephone Number	:	609-892-2995
Fax Number	:

Provider Business Practice Location Address
First Line	:	1653 BEACH AVE
Second Line	:
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-1607
Country	:	US
Telephone Number	:	609-892-2995
Fax Number	:

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

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	05/23/2008

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Directions to “ MRS. CATHY TUCKER LLPN” Practice Location

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