Provider Demographics
NPI:1508907791
Name:TUCCI, CORRINE M (RN)
Entity Type:Individual
Prefix:MRS
First Name:CORRINE
Middle Name:M
Last Name:TUCCI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9710
Mailing Address - Country:US
Mailing Address - Phone:570-265-2191
Mailing Address - Fax:570-265-0932
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-9710
Practice Address - Country:US
Practice Address - Phone:570-265-2191
Practice Address - Fax:570-265-0932
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN180928L163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011196310001Medicaid