Provider Demographics
NPI:1548473085
Name:TUCKER, DENISE ANNETTE (RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANNETTE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 REDWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2731
Mailing Address - Country:US
Mailing Address - Phone:850-878-7981
Mailing Address - Fax:
Practice Address - Street 1:454 DUXBURY HALL
Practice Address - Street 2:FLORIDA STATE UNIVERSITY COLLEGE OF NURSING
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306-4310
Practice Address - Country:US
Practice Address - Phone:850-644-5675
Practice Address - Fax:850-644-7660
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 1400992163W00000X
GARN066918163W00000X
AL1-062546163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse