Provider Demographics
NPI:1770721375
Name:TUCKER, BARBARA A (CNS-BC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:TUCKER
Suffix:
Gender:F
Credentials:CNS-BC
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 636930
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-981-5123
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:770 W HIGH ST
Practice Address - Street 2:SUITE 450
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3990
Practice Address - Country:US
Practice Address - Phone:419-996-5240
Practice Address - Fax:419-996-5242
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH304386364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2970076Medicaid
OH2970076Medicaid