Provider Demographics
NPI:1831655042
Name:TUCKER, MELINDA (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:TORDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE.
Mailing Address - Street 2:MS# 1118
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614
Mailing Address - Country:US
Mailing Address - Phone:419-383-3697
Mailing Address - Fax:419-383-3041
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3697
Practice Address - Fax:419-383-3041
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily