Provider Demographics
NPI:1508173451
Name:TUCKER, DENEEN LATASHA
Entity Type:Individual
Prefix:MS
First Name:DENEEN
Middle Name:LATASHA
Last Name:TUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 TOWNTERRACE DR
Mailing Address - Street 2:APT 7
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1180
Mailing Address - Country:US
Mailing Address - Phone:513-371-2606
Mailing Address - Fax:
Practice Address - Street 1:2750 TOWNTERRACE DR
Practice Address - Street 2:APT 7
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1180
Practice Address - Country:US
Practice Address - Phone:513-371-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN356376163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse