MEDICARE: CAMERON TUCKER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1679416739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON TUCKER

Provider Business Mailing Address
First Line	:	2502 OGDEN AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-2407
Country	:	US
Telephone Number	:	330-962-7271
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 OGDEN AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-2407
Country	:	US
Telephone Number	:	330-962-7271
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ CAMERON TUCKER ” Practice Location

Language	Start Address	Practice Location

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