Provider Demographics
NPI:1962448001
Name:TUCKER, EARNESTINE J (CRNP)
Entity Type:Individual
Prefix:PROF
First Name:EARNESTINE
Middle Name:J
Last Name:TUCKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:701 UNIVERSITY BLVD E
Mailing Address - Street 2:SUITE 507
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2086
Mailing Address - Country:US
Mailing Address - Phone:205-752-9500
Mailing Address - Fax:205-752-9662
Practice Address - Street 1:701 UNIVERSITY BLVD E
Practice Address - Street 2:SUITE 507
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-7432
Practice Address - Country:US
Practice Address - Phone:205-752-9500
Practice Address - Fax:205-752-9662
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-020764363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health