Kristen Elaine Tucker, PA-C
Physician Assistant in Jacksonville, FL. Individual provider (NPI-1).
NPI number1457785263
StatusActive
Last updated in NPPESJun 10, 2014
Details
- NPI
- 1457785263
- Entity type
- Individual (NPI-1)
- Name
- Kristen Elaine Tucker
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 28, 2013
- Last updated
- Jun 10, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9104439 | FL | Yes |
| 363AM0700X | Physician Assistant, Medical | PA9104439 | FL |
Practice location
1 Shircliff WayJacksonville, FL 32204-4748
Phone 904-308-7497 · Fax 954-858-0404
Mailing address
1500 Concord TerSunrise, FL 33323-2815
Phone 800-243-3839 · Fax 954-858-0404
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