Provider Demographics
NPI:1760030795
Name:TUCKER, JOSHUA B (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:B
Last Name:TUCKER
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:LAUREL FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24352-0009
Mailing Address - Country:US
Mailing Address - Phone:276-398-1200
Mailing Address - Fax:540-365-4272
Practice Address - Street 1:180 FERRUM MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FERRUM
Practice Address - State:VA
Practice Address - Zip Code:24088-2939
Practice Address - Country:US
Practice Address - Phone:540-365-4469
Practice Address - Fax:540-365-4272
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178347363LF0000X
VA0001226896163WD1100X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis