Provider Demographics
NPI:1003895640
Name:TUCKER, VERNITA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:VERNITA
Middle Name:ANN
Last Name:TUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VERNITA
Other - Middle Name:ANN TATE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1005 DR. D. B. TODD BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208
Mailing Address - Country:US
Mailing Address - Phone:615-327-5524
Mailing Address - Fax:615-327-5541
Practice Address - Street 1:1005 DR. D. B. TODD BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-5524
Practice Address - Fax:615-327-5541
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN024603207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3076238Medicaid
TN3076238Medicare ID - Type Unspecified
TN3076238Medicaid