Amanda Kayleigh Tucker
Case Manager/Care Coordinator in Shreveport, LA. Individual provider (NPI-1).
NPI number1649862004
StatusActive
Last updated in NPPESFeb 8, 2021
Details
- NPI
- 1649862004
- Entity type
- Individual (NPI-1)
- Name
- Amanda Kayleigh Tucker
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 8, 2021
- Certification date
- Feb 8, 2021
- Last updated
- Feb 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
856 Texas AveShreveport, LA 71101-3400
Phone 318-429-6938 · Fax 318-629-2870
Mailing address
856 Texas AveShreveport, LA 71101-3400
Phone 318-429-6938
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