LISA TUCKER (NPI# 1992166490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992166490 |
Entity Type | Individual |
Full Name | LISA TUCKER |
Credential | RN, CPNP-PC |
Practice Address |
2510 E Dupont Rd Suite 238 Fort Wayne IN 46825-1600 |
Practice Telephone | 8552007337 |
Mailing Telephone | 8552007337 |
Enumeration Date | 2016-03-10 |
Last Update Date | 2016-03-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
28144452A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 1275546913 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679093462 | Lisa Moore Tucker | Registered Nurse | 5 Richland Medical Park Dr Ste 305, Columbia, SC 29203-6863 | 2017-06-22 |
1245609205 | Lisa V Tucker | Social Worker | 2505 Main St Ste 231, Stratford, CT 06615-5839 | 2015-09-21 |
1952600884 | Lisa Tucker | Home Health | 15003 Turtle Lake Ct, Lutz, FL 33559-7734 | 2011-03-17 |
1295344554 | Lisa Tucker | Case Manager/Care Coordinator | 589 Midway Rd, Alum Creek, WV 25003-9577 | 2020-07-23 |
1063076214 | Lisa Tucker | Counselor | 791 N Pepper Ave, Colton, CA 92324-1800 | 2019-04-23 |
1336556620 | Lisa Tucker | Dietitian, Registered | 2441 S Highway 27, Somerset, KY 42501-2935 | 2014-07-18 |
1467522490 | Lisa A Tucker | Nurse Practitioner | 900 Pacific Ave Ste 500, Everett, WA 98201-4189 | 2006-11-08 |
Street Address |
2510 E DUPONT RD SUITE 238 |
City | FORT WAYNE |
State | IN |
Zip Code | 46825-1600 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306838321 | Althea J. Jackson | Obstetrics & Gynecology | 2510 E Dupont Rd, Suite 100, Fort Wayne, IN 46825-1600 | 2005-08-16 |
1821459413 | Kids.healthcare PC | Pediatrics | 2510 E Dupont Rd, Suite 238, Fort Wayne, IN 46825-1600 | 2016-03-10 |
1447634449 | Associated Surgeons and Physicians, LLC | Pediatrics | 2510 E Dupont Rd, Suite 200, Fort Wayne, IN 46825-1601 | 2015-07-20 |
1124459276 | Fw Interventional Pain Management LLC | Anesthesiology | 2510 E Dupont Rd, Suite 115, Fort Wayne, IN 46825-1600 | 2013-11-27 |
1396080156 | T-med Services, Inc | Psychologist | 2510 E Dupont Rd, Suite 201, Fort Wayne, IN 46825-1601 | 2012-12-05 |
1326222480 | Daniel E. Krach, M.d. | Eyewear Supplier (Equipment, not the service) | 2510 E Dupont Rd, Suite 128, Fort Wayne, IN 46825-1600 | 2007-12-26 |
1497958946 | Northeast Foot & Ankle Clinic Inc | Podiatrist | 2510 E Dupont Rd, Ste. 234, Fort Wayne, IN 46825-1600 | 2007-06-11 |
1013078351 | Osita Victor Ezeakudo | Pediatrics | 2510 E Dupont Rd, Suite 200, Fort Wayne, IN 46825-1601 | 2006-12-12 |
1700809175 | Arnold Brill | Specialist | 2510 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2006-07-25 |
1558314039 | Three Rivers Surgical Associates, LLC | Surgery | 2510 E Dupont Rd, Suite 210, Fort Wayne, IN 46825-1600 | 2006-05-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
Find all providers in zip 46825 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588947543 | Denise A Gilham | Nurse Practitioner | 7950 W Jefferson Blvd Fl 2, Fort Wayne, IN 46804-4140 | 2011-09-26 |
1578658191 | Nancy A Pyle | Nurse Practitioner | 1717 South Calhoun, Fort Wayne, IN 46802 | 2006-10-03 |
1265047138 | Josiah Wesley Reish | Nurse Practitioner | 7613 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-4182 | 2020-09-09 |
1912522418 | Danica Mitten | Nurse Practitioner | 3919 W Jefferson Blvd, Fort Wayne, IN 46804-6811 | 2020-06-10 |
1083266852 | Mikala Schmidt | Nurse Practitioner | 2810 Dupont Commerce Ct, Fort Wayne, IN 46825-2393 | 2019-07-11 |
1154872653 | Amanda M Leisure | Nurse Practitioner | 11141 Parkview Plaza Dr Ste 210, Fort Wayne, IN 46845-1714 | 2016-10-19 |
1609320795 | Clare Hall | Nurse Practitioner | 10228 Dupont Circle Dr E, Fort Wayne, IN 46825-1611 | 2016-08-07 |
1710396940 | Bernita Flye | Nurse Practitioner | 3919 W Jefferson Blvd, Fort Wayne, IN 46804-6811 | 2014-08-13 |
1508299751 | Angela Scheid | Nurse Practitioner | 3301 Lake Ave, Fort Wayne, IN 46805-5529 | 2013-08-12 |
1972790608 | Diana L Case | Nurse Practitioner | 2514 E Dupont Rd, Suite 100, Fort Wayne, IN 46825-1623 | 2007-09-26 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46825 |
Please comment or provide details below to improve the information on LISA 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.