Provider Demographics
NPI:1770230518
Name:TUCKER, EMILY ELIZABETH (CBD, CPD, CBC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:TUCKER
Suffix:
Gender:F
Credentials:CBD, CPD, CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 KILGORE ST
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-3940
Mailing Address - Country:US
Mailing Address - Phone:352-300-8650
Mailing Address - Fax:
Practice Address - Street 1:506 KILGORE ST
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-3940
Practice Address - Country:US
Practice Address - Phone:352-300-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty