Provider Demographics
NPI:1326491200
Name:TUCKER, TOBI ETIENNE BOWMAN (RN)
Entity Type:Individual
Prefix:MS
First Name:TOBI
Middle Name:ETIENNE BOWMAN
Last Name:TUCKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12801 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 1750
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1716
Mailing Address - Country:US
Mailing Address - Phone:877-293-6287
Mailing Address - Fax:888-512-9116
Practice Address - Street 1:12801 N CENTRAL EXPY
Practice Address - Street 2:SUITE 1750
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1716
Practice Address - Country:US
Practice Address - Phone:877-293-6287
Practice Address - Fax:888-512-9116
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN65388163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse