MEDICARE: ELAINE 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	163W00000X	Registered Nurse	95402957	CA
2	163W00000X	Registered Nurse	N03157	NY
3	163W00000X	Registered Nurse	1639976	CO
4	163W00000X	Registered Nurse	230944	AK

General Provider Information

NPI Number	:	1992670780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE TUCKER RN

Provider Business Mailing Address
First Line	:	2374 HUDSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3260
Country	:	US
Telephone Number	:	404-402-7696
Fax Number	:

Provider Business Practice Location Address
First Line	:	2374 HUDSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3260
Country	:	US
Telephone Number	:	404-402-7696
Fax Number	:

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

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	10/09/2025

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Directions to “ ELAINE TUCKER RN” Practice Location

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