Tucker, Mary Knuth
Tucker, Mary Knuth is an individual health care provider with primary practice located at 1405 Willow Ln Suite A, North Wilkesboro NC 28659-3551. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tucker, Mary Knuth can be contacted via phone (336) 667-0335.Contact Information
Primary practice address
1405 Willow Ln Suite A
North Wilkesboro NC 28659-3551
Phone: (336) 667-0335
Fax: (336) 667-4434
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 200814 | North Carolina |
Profile Details
| NPI number | 1942299789 |
|---|---|
| LBN Legal business name | Tucker, Mary Knuth |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Dec 11th, 2013 - about 13 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 | 1942299789 | NPPES |
| South Carolina | Other | 0481610001 | DMERC/PGBA |
| South Carolina | Other | 0575 | DMERC/PGBA |
| South Carolina | MEDICAID | 8902938 | DMERC/PGBA |
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