MEDICARE: TAMMI TUCKER RN

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	101YM0800X	Mental Health Counselor	RN073102	LA
2	163W00000X	Registered Nurse	RN073102	LA

General Provider Information

NPI Number	:	1881067684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMI TUCKER RN

Provider Business Mailing Address
First Line	:	4313 KAREN AVE
Second Line	:
City	:	JEFFERSON
State	:	LA
Zip	:	70121-1330
Country	:	US
Telephone Number	:	504-539-2482
Fax Number	:

Provider Business Practice Location Address
First Line	:	4120 EVE ST.
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125
Country	:	US
Telephone Number	:	504-304-3737
Fax Number	:	888-709-6045

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

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	11/03/2015

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Directions to “ TAMMI TUCKER RN” Practice Location

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