Provider Demographics
NPI:1811357601
Name:TUCKER, NIKIA (CRNP)
Entity type:Individual
Prefix:
First Name:NIKIA
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2726
Mailing Address - Country:US
Mailing Address - Phone:412-415-3647
Mailing Address - Fax:
Practice Address - Street 1:211 N WHITFIELD ST
Practice Address - Street 2:410
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3039
Practice Address - Country:US
Practice Address - Phone:412-361-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015979363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily