Provider Demographics
NPI:1942339866
Name:TUCEK, NANCY E (NURSE)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:TUCEK
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 DOYLES CT
Mailing Address - Street 2:
Mailing Address - City:RIO RICO
Mailing Address - State:AZ
Mailing Address - Zip Code:85648-6606
Mailing Address - Country:US
Mailing Address - Phone:520-377-2021
Mailing Address - Fax:
Practice Address - Street 1:310 W PLUM ST
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-2613
Practice Address - Country:US
Practice Address - Phone:520-287-0800
Practice Address - Fax:520-287-0816
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN113592251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)