JERRY DEWAYNE TUCKER (NPI# 1407998404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407998404 |
| Entity Type | Individual |
| Full Name | JERRY DEWAYNE TUCKER |
| Practice Address |
Us Coast Guard Special Missions Training Center Bb-11 Courthouse Bay Camp Lejeune NC 28542 |
| Practice Telephone | 9103760773 |
| Practice Fax Number | 9104507040 |
| Mailing Telephone | 9103760773 |
| Mailing Fax Number | 9104507040 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QM0706X |
Spec/Tech, Pathology Specialization: Medical Technologist |
Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720522527 | Jerry Tucker IIi | Massage Therapist | 18336 Avon Ave, Detroit, MI 48219-2954 | 2016-12-13 |
| 1740564343 | Jerry Alton Tucker Jr. | Pharmacist | 3050 Ashley Town Center Dr, Charleston, SC 29414-5664 | 2011-10-01 |
| Street Address |
US COAST GUARD SPECIAL MISSIONS TRAINING CENTER BB-11 COURTHOUSE BAY |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794439 | Lauren Marie Barton | Dentist | H M Smith Blvd, Bldg Fc-308, Camp Lejeune, NC 28542 | 2020-09-10 |
| 1003444928 | Andres Martin Rodoni | Military Health Care Provider | 2nd Reconnaissance Battalion, Camp Lejune, NC 28542 | 2020-03-27 |
| 1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
| 1881243525 | Alexander Thomas Rodgers | Military Health Care Provider | 2nd Raider Battalion, A66 Boat Basin Rd, Camp Lejeune, NC 28542 | 2019-09-05 |
| 1992352454 | Kirsten Janel Snow | Physician Assistant | Hm Smith Boulevard, Bldg Fc-308, Camp Lejeune, NC 28542 | 2019-08-20 |
| 1639735947 | Cody Robert Patton | Military Health Care Provider | 3rd Marine Raider Battalion, Bldg 614, Camp Lejeune, Nc, NC 28542 | 2019-05-13 |
| 1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
| 1578032504 | Brendon Earl Dumas | Military Health Care Provider | Rr612 Everett Creek Road, Camp Lejeune, NC 28542 | 2018-11-20 |
| 1053896514 | Roy Atallah | Military Health Care Provider | 2nd Marine Raider Battalion, Camp Lejeune, NC 28542 | 2018-10-01 |
| 1316422975 | Zachary Thomas Monahan | General Practice | Hm Smith Boulevard Bldg Fc-308, Camp Lejeune, NC 28542 | 2018-09-30 |
| Find all providers in zip 28542 | ||||
| Taxonomy Code | 246QM0706X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Medical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973685 | Roderick Kirby | Spec/Tech, Pathology | 2429 Ardmore Mnr, Winston Salem, NC 27103-4801 | 2020-08-19 |
| 1912515883 | Jennifer Anne Swift | Spec/Tech, Pathology | 14 Circuit Dr Rm 116, Durham, NC 27710-3051 | 2020-07-16 |
| 1255973095 | Heather Lynn Bronder | Spec/Tech, Pathology | 93 Old Forest Dr, Asheville, NC 28803-0280 | 2019-10-14 |
| 1124568407 | Kelly Almond | Spec/Tech, Pathology | 49256 Parker Memorial Rd, Richfield, NC 28137-5756 | 2017-03-06 |
| 1013302116 | William Bryan | Spec/Tech, Pathology | 3738 Cypress Club Dr, Villa D403, Charlotte, NC 28210-2483 | 2015-04-06 |
| 1992034722 | Victoria Thuy-viet Phan | Spec/Tech, Pathology | 109 Wrenn Dr Apt A, Cary, NC 27511-5316 | 2009-12-07 |
| 1699913558 | Lynn Stavely | Spec/Tech, Pathology | 6400 Green Arbor Ln, Wilmington, NC 28409-2136 | 2009-01-30 |
| 1194981977 | David Lee Harwood | Spec/Tech, Pathology | 1075 Jenkins Valley Rd, Alexander, NC 28701-8712 | 2008-07-31 |
| 1144417643 | Deborah Evans Griffin | Spec/Tech, Pathology | 383 Miriam Dr, Winston Salem, NC 27127-9169 | 2007-09-28 |
| 1386797967 | Karol Linmar Anglero | Spec/Tech, Pathology | 7664 Silver View Ln, Raleigh, NC 27613-1439 | 2007-01-19 |
| Find all providers with the same taxonomy | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28542 |
Please comment or provide details below to improve the information on JERRY DEWAYNE TUCKER.
| 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.