Tucker, Lisa
Tucker, Lisa is an individual health care provider with primary practice located at 2510 E Dupont Rd Suite 238, Fort Wayne IN 46825-1600. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Tucker, Lisa can be contacted via phone (855) 200-7337.Contact Information
Primary practice address
2510 E Dupont Rd Suite 238
Fort Wayne IN 46825-1600
Phone: (855) 200-7337
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 28144452A | Indiana |
Profile Details
| NPI number | 1992166490 |
|---|---|
| LBN Legal business name | Tucker, Lisa |
| Credentials | RN, CPNP-PC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2016 |
| Last updated | Mar 10th, 2016 - about 9 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 | 1992166490 | NPPES |
| Indiana | MEDICAID | 1275546913 |
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