Tucker, Mary W

Tucker, Mary W is an individual health care provider with primary practice located at 116 Chantilly Lane , Maryville TN 37803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Tucker, Mary W can be contacted via phone (865) 273-1616.

Contact Information

Primary practice address
116 Chantilly Lane Maryville TN 37803
Phone: (865) 273-1616
Fax: (865) 273-1645
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APN0000010443 Tennessee

Profile Details

NPI number 1386775641
LBN Legal business name Tucker, Mary W
Credentials APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2007
Last updated Feb 19th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386775641 NPPES
Tennessee Other APN0000010443 LICENSE
Tennessee MEDICAID 3341063 LICENSE

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