Kenneth Wayne Tucker, RN
Registered Nurse, Community Health in Ruston, LA. Individual provider (NPI-1).
NPI number1114280997
StatusActive
Last updated in NPPESJun 18, 2012
Details
- NPI
- 1114280997
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kenneth Wayne Tucker
- Credential
- RN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 18, 2012
- Last updated
- Jun 18, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WC1500X | Registered Nurse, Community Health | RN106423 | LA | Yes |
Practice location
405 E Georgia AveRuston, LA 71270-3926
Phone 318-251-4120 · Fax 318-251-4181
Mailing address
802 Marion HwyFarmerville, LA 71241-9215
Phone 318-368-7283
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