SHANNON L TUCKER


Address: 3009 N Ballas Rd, Ste 264c, Saint Louis, MO 63131-2322
Phone: 3149967940

SHANNON L TUCKER (NPI# 1386048023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386048023
Entity Type Individual
Full Name SHANNON L TUCKER
Other Name SHANNON L STOVER
Credential AGPCNP
Practice Address 3009 N Ballas Rd
Ste 264c
Saint Louis
MO 63131-2322
Mailing Address 670 Mason Ridge Center Dr
Ste 300
Saint Louis
MO 63141-8573
Practice Telephone 3149967940
Practice Fax Number 3149967945
Mailing Telephone 3149967940
Mailing Fax Number 3149967945
Enumeration Date 2014-10-09
Last Update Date 2016-04-11
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 2006019382 MO Nursing Service Providers
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
2014036832 MO Physician Assistants & Advanced Practice Nursing Providers

Other Providers SHANNON TUCKER

NPI Name Taxonomy Address Enumeration
1972165926 Shannon D Tucker Case Manager/Care Coordinator 1921 Ransom Pl, Nashville, TN 37217-3841 2019-06-30
1184102642 Shannon E Tucker Licensed Vocational Nurse 9846 Hwy 31 E, Tyler, TX 75705-2329 2018-08-06
1730575218 Shannon Tucker Physician Assistant 1215 Lee St, Charlottesville, VA 22908-4500 2015-04-10
1194140517 Shannon L Tucker Psychologist 1 Rapp Rd, Albany, NY 12203 2014-02-21
1174874838 Shannon Schou Tucker Counselor 1776 S Jackson St, Suite 700, Denver, CO 80210-3801 2012-09-21
1073817565 Shannon Renee Tucker Counselor 7777 E Us Highway 66, El Reno, OK 73036-9125 2010-12-27
1346322112 Shannon Lynn Tucker Speech-Language Pathologist 210 E Woodlawn Rd, Suite 150, Charlotte, NC 28217-2202 2006-10-20

Office Location

Street Address 3009 N BALLAS RD
STE 264C
City SAINT LOUIS
State MO
Zip Code 63131-2322

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043214505 Lee S Portnoff Dermatology 3009 N Ballas Rd, Ste 310a, Saint Louis, MO 63131-2353 2005-06-11
1255878054 John William Molitor Jr. Nurse Practitioner 3009 N Ballas Rd, Suite 323a, Saint Louis, MO 63131-2322 2017-01-31
1669922068 Melanie Huff Registered Nurse 3009 N Ballas Rd, Ste 207b, Saint Louis, MO 63131-2322 2016-10-10
1518410810 Alison Olivo Audiologist 3009 N Ballas Rd, Ste 380c, Saint Louis, MO 63131-2322 2016-08-03
1225483274 Stacey Smith Social Worker 3009 N Ballas Rd, Building A, Suite 228, Saint Louis, MO 63131-2322 2016-04-27
1386005874 Megan K Sipes Nurse Practitioner 3009 N Ballas Rd, Ste 264c, Saint Louis, MO 63131-2322 2016-03-11
1962867457 Joseph Ryan Walsh Physician Assistant 3009 N Ballas Rd, Suite 304a, Saint Louis, MO 63131-2322 2015-12-28
1114321916 Erin Desmarais Audiologist 3009 N Ballas Rd, Ste 351c, Saint Louis, MO 63131-2322 2014-10-22
1700287059 Julia Rudy Nurse Anesthetist, Certified Registered 3009 N Ballas Rd, Suite 371, Saint Louis, MO 63131-2322 2014-09-05
1518367176 Stephanie M Noeth Nurse Practitioner 3009 N Ballas Rd, Ste 380c, Saint Louis, MO 63131-2322 2014-09-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568097954 Avalcare Inc Pharmacy 10431 Clayton Rd, Saint Louis, MO 63131 2020-03-06
1891331369 Life Clinic of Mo Dc PC Chiropractor 2051 South Lindbergh Blvd, Frontenac, MO 63131 2019-11-20
1447892542 Jand. Inc. Eyewear Supplier (Equipment, not the service) 30 S Lindbergh Blvd, Saint Louis, MO 63131 2019-10-10
1336797026 Justa Davis Dietitian, Registered 3015 North Ballas, Saint Louis, MO 63131 2019-08-27
1730695362 Curators of The University of Missouri Psychologist 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 2017-12-19
1770012031 Danielle Marie Hargate Specialist/Technologist 732 Timber Trail, Frontenac, MO 63131 2017-06-08
1285087429 Kathryn Parker Internal Medicine 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 2016-07-22
1437524360 Julie Ann Godefroid Nurse Practitioner 1010 Old Des Peres Road, St. Louis, MO 63131 2015-12-03
1073982435 Rebecca Baum Rainbolt Social Worker 12210 Clayton Rd, Saint Louis, MO 63131 2015-09-16
1518217322 Advanced Anesthesia and Pain Management, LLC Anesthesiology 12805 Topping Woods Estate Drive, St. Louis, MO 63131 2012-09-19
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023619285 Jennifer Lee Speiser Nurse Practitioner 12545 Olive Blvd, Saint Louis, MO 63141-6311 2020-11-04
1265045264 Andrea Jane Montgomery Nurse Practitioner 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 2020-08-28
1396362224 Erin M Kehoe Nurse Practitioner 12973 Olive Blvd, Saint Louis, MO 63141-6149 2020-06-26
1508482506 Matthew Dale Tieskoetter Nurse Practitioner 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 2020-06-25
1861033615 Benedicta Esi Nurse Practitioner 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 2019-10-02
1245896893 Katina D Smith Nurse Practitioner 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 2019-05-18
1912413584 Lucija Kozul Sadl Nurse Practitioner 3525 Forest Dale Dr, Saint Louis, MO 63125-4212 2017-12-19
1275071326 Kathryn Ries Nurse Practitioner 3535 South Broadway, Suite 118, Saint Louis, MO 63118-3907 2017-02-09
1144775966 Hienok Hailu Nurse Practitioner 11725 Casa Grande Dr, Saint Louis, MO 63146-4223 2016-08-22
1992167522 Lanyn Clark Nurse Practitioner 40 Ladue Ter, Saint Louis, MO 63124-2048 2016-03-23
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Competitor

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City SAINT LOUIS
Zip Code 63131

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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