Provider Demographics
NPI:1356134084
Name:TUCKER, TAYLOR NICOLE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICOLE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18002 ROAD K
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45827-9652
Mailing Address - Country:US
Mailing Address - Phone:567-376-0078
Mailing Address - Fax:
Practice Address - Street 1:18002 ROAD K
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:OH
Practice Address - Zip Code:45827-9652
Practice Address - Country:US
Practice Address - Phone:567-376-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker