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Lisa Tucker, RN,CPNP-PC
Pediatric Nurse Practitioner in Fort Wayne, Indiana
NPI 1992166490

Lisa Tucker is a Pediatric Nurse Practitioner based in Fort Wayne, IN and is specialized in Pediatrics. Lisa Tucker practices in Fort Wayne, IN and has the professional credentials of RN,CPNP-PC. The NPI Number for Lisa Tucker is 1992166490 and holds a License No. 28144452A (Indiana).

The current practice location address for Lisa Tucker is 2510 E Dupont Rd, Fort Wayne, IN and can be reached out via phone at 855-200-7337.

Location: 2510 E Dupont Rd, Fort Wayne, IN, 46825-1600
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992166490
Provider Name
Lisa Tucker
Credential
RN,CPNP-PC
Provider Entity Type
Individual
Gender
Female
Address
2510 E Dupont Rd, Fort Wayne, IN, 46825-1600
Phone Number
855-200-7337
Fax Number
Provider Enumeration Date
03/10/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1275546913 05 IN
institution
Provider Business Practice Location Address Details
Address
2510 E Dupont Rd
City
Fort Wayne
State
Indiana
Zip
46825-1600
Phone Number
855-200-7337
Fax Number
person
Provider Business Mailing Address Details
Address
2510 E Dupont Rd
City
Fort Wayne
State
Indiana
Zip
46825-1600
Phone Number
855-200-7337
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
28144452A (Indiana)
Definition
Definition to come...
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