Provider Demographics
NPI:1730489345
Name:TUCCI, ALYSON LYNN
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:LYNN
Last Name:TUCCI
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 1:874 FAIRWAY ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-4011
Mailing Address - Country:US
Mailing Address - Phone:715-499-1124
Mailing Address - Fax:
Practice Address - Street 1:874 FAIRWAY ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-4011
Practice Address - Country:US
Practice Address - Phone:715-499-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313303-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse