Kaysha Tucker, LPN
Licensed Practical Nurse in Warren, OH. Individual provider (NPI-1).
NPI number1164020467
StatusActive
Last updated in NPPESOct 9, 2020
Details
- NPI
- 1164020467
- Entity type
- Individual (NPI-1)
- Name
- Kaysha Tucker
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 9, 2020
- Certification date
- Oct 9, 2020
- Last updated
- Oct 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | LPN175729-MEDS-IV | OH | Yes |
Practice location
3120 W Market StWarren, OH 44485-3069
Phone 330-898-6992
Mailing address
535 Marmion AveYoungstown, OH 44502-2323
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