Provider Demographics
NPI:1497711204
Name:TUCKER, DENISE WHICKER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:WHICKER
Last Name:TUCKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 HOLLYHOCK WAY
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163-2241
Mailing Address - Country:US
Mailing Address - Phone:336-817-0035
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF VETERANS AFFAIRS OPC
Practice Address - Street 2:190 KIMEL PARK DRIVE
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-768-3296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist