MALLORY PAIGE TUCKER (NPI# 1861751349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861751349 |
Entity Type | Individual |
Full Name | MALLORY PAIGE TUCKER |
Credential | PA-C |
Practice Address |
2452 Mahan Dr Suite 101 Tallahassee FL 32308-5373 |
Mailing Address |
3452 Mahan Drive Sutie 101 Tallahassee FL 32308-0000 |
Practice Telephone | 8508772126 |
Practice Fax Number | 8508785190 |
Mailing Telephone | 8508772126 |
Mailing Fax Number | 8508775190 |
Enumeration Date | 2012-05-03 |
Last Update Date | 2013-05-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9106576 | FL | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194369850 | Mallory Tucker | Behavior Technician | 7328 Arbor Trl Apt 201, Waterford, MI 48327-4501 | 2019-11-05 |
1790039592 | Mallory Tucker | Dentist | 1114 Dolores St, San Francisco, CA 94110-3613 | 2012-10-31 |
1023621794 | Mallory Keck Tucker | Pharmacist | 102 E Broadway, Newport, TN 37821-2323 | 2020-08-24 |
1376980482 | Mallory Conway Tucker | Nurse Practitioner | 701 Doctors Dr, Suite N, Kinston, NC 28501-1589 | 2013-05-30 |
Street Address |
2452 MAHAN DR SUITE 101 |
City | TALLAHASSEE |
State | FL |
Zip Code | 32308-5373 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861474132 | Jeffrey M Rawlings | Plastic Surgery | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5373 | 2005-11-14 |
1720347438 | Toni Piper | Registered Nurse | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5373 | 2012-05-15 |
1326181314 | Alamarcon Holdings, LLC | Clinic/Center | 2452 Mahan Dr, Suite 102, Tallahassee, FL 32308 | 2007-02-15 |
1366557696 | Jayne H Mittan | Physician Assistant | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5377 | 2006-08-19 |
1710951967 | H. Louis Hill Jr. | Plastic Surgery | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5377 | 2006-02-15 |
1982678132 | Alfredo A Paredes Jr. | Plastic Surgery | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5377 | 2006-02-15 |
1548234057 | Larry L Harper | Plastic Surgery | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5377 | 2006-02-14 |
1043284474 | Hill, Harper and Paredes, Pa | Plastic Surgery | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5377 | 2006-02-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
Find all providers in zip 32308 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396306106 | Max Hyunmin Oh | Physician Assistant | 2631 Centennial Blvd Ste 100, Tallahassee, FL 32308-0591 | 2019-06-23 |
1245575935 | Sharon Sanford Banasiewicz | Physician Assistant | 2452 Mahan Dr Ste 101, Tallahassee, FL 32308-5377 | 2012-12-06 |
1679838734 | Andrew R Perrin | Physician Assistant | 1300 Medical Dr, Tallahassee, FL 32308-4646 | 2012-07-05 |
1366557696 | Jayne H Mittan | Physician Assistant | 2452 Mahan Dr, Suite 101, Tallahassee, FL 32308-5377 | 2006-08-19 |
1831109412 | Mark L Marcewicz | Physician Assistant | 1911 Miccosukee Rd, Tallahassee, FL 32308-5321 | 2006-08-08 |
1992750038 | David Widlund Brown | Physician Assistant | 1405 Centerville Rd, Suite 5000, Tallahassee, FL 32308-4655 | 2006-05-24 |
1851364442 | Scott L Krueger | Physician Assistant | 3334 Capital Medical Blvd, Suite 400, Tallahassee, FL 32308-8405 | 2006-02-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811598691 | Monica Nancy Ginocchio | Physician Assistant | 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 | 2020-11-06 |
1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
1104436476 | Forrest Joseph Steslow | Physician Assistant | 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 | 2020-08-03 |
1063039576 | Joshua Bras Prewitt | Physician Assistant | 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 | 2020-06-30 |
1003443904 | Sheila Rhinehart | Physician Assistant | 981 Tarpon Ave, Sebastian, FL 32958-5147 | 2020-03-23 |
1952932493 | Lisel Spieler | Physician Assistant | 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 | 2020-02-03 |
1326685991 | Nikolai X Lincavage | Physician Assistant | 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 | 2019-12-03 |
1356984686 | Zane K Jude | Physician Assistant | 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 | 2019-10-18 |
1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
Find all providers with the same taxonomy |
City | TALLAHASSEE |
Zip Code | 32308 |
Please comment or provide details below to improve the information on MALLORY PAIGE 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.