Provider Demographics
NPI:1710638382
Name:TUCKER, ZIPPORAH
Entity Type:Individual
Prefix:
First Name:ZIPPORAH
Middle Name:
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 1:26649 DUBLIN WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7224
Mailing Address - Country:US
Mailing Address - Phone:239-365-5045
Mailing Address - Fax:239-365-5044
Practice Address - Street 1:26649 DUBLIN WOODS CIR
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7224
Practice Address - Country:US
Practice Address - Phone:239-365-5045
Practice Address - Fax:239-365-5044
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide