Tucker, Kathy Jeanne
Tucker, Kathy Jeanne is an sole proprietor health care provider with primary practice located at 1513 Boulder Way , Sun Prairie WI 53590-1253. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Tucker, Kathy Jeanne can be contacted via phone (608) 837-6152.Contact Information
Primary practice address
1513 Boulder Way
Sun Prairie WI 53590-1253
Phone: (608) 837-6152
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant | 224Z00000X | 254-027 | Wisconsin |
Profile Details
| NPI number | 1164622585 |
|---|---|
| LBN Legal business name | Tucker, Kathy Jeanne |
| Credentials | Certified Occupational Therapy Assistant (COTA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 23rd, 2007 |
| Last updated | Sep 4th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164622585 | NPPES |
| Wisconsin | MEDICAID | 40691700 |
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