MEDICARE: FRANCHESCA CHEVONNE 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95015689	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	192714	MD

General Provider Information

NPI Number	:	1578186417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCHESCA CHEVONNE TUCKER

Provider Business Mailing Address
First Line	:	10530 CAMPUS WAY S
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-1309
Country	:	US
Telephone Number	:	240-602-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	1114 YUBA ST
Second Line	:	STE 220
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-1309
Country	:	US
Telephone Number	:	240-816-4358
Fax Number	:

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

Provider Enumeration Date	:	05/27/2020
Last Update Date	:	03/24/2022

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Directions to “ FRANCHESCA CHEVONNE TUCKER ” Practice Location

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