Provider Demographics
NPI:1437100195
Name:TUCKER, HOLLY A (NP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:A
Last Name:TUCKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 THISTLE CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-9611
Mailing Address - Country:US
Mailing Address - Phone:615-973-7208
Mailing Address - Fax:
Practice Address - Street 1:430 LONG HOLLOW PIKE
Practice Address - Street 2:SUITE E
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3488
Practice Address - Country:US
Practice Address - Phone:615-859-8081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN99652163W00000X
TNAPN0000006978363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health