Provider Demographics
NPI:1083332605
Name:TUCKER, ELIZABETH A (RPSGT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:TUCKER
Suffix:
Gender:F
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9568 W GIBRALTAR PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-8560
Mailing Address - Country:US
Mailing Address - Phone:720-454-7580
Mailing Address - Fax:
Practice Address - Street 1:9568 W GIBRALTAR PL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-8560
Practice Address - Country:US
Practice Address - Phone:720-454-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2755261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic