Provider Demographics
NPI:1619302304
Name:JONES, ANN TUCKER (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:TUCKER
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:CLARE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2201 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2944
Mailing Address - Country:US
Mailing Address - Phone:310-753-4153
Mailing Address - Fax:310-545-7294
Practice Address - Street 1:2201 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2944
Practice Address - Country:US
Practice Address - Phone:310-753-4153
Practice Address - Fax:310-545-7294
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255657163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool