Most Relevant Information
Provider Data
| NPI Number: | 1003682972 |
| Provider Name: | STACY MARIE TUCKER RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC1500X |
| Specialty: | Registered Nurse |
| License Number: | 662818 |
Most Important Dates
| Enumeration Date: | 11/30/2023 |
| Last Updated: | 11/30/2023 |
Provider Practice Location
1150 BROOKSIDE AVE STE U
REDLANDS
CA
923736304
Practice Location Phone/Fax
| Phone: | 9093354131 |
| Fax: |
Provider Mailing Location
1150 BROOKSIDE AVE STE U
REDLANDS
CA
923736304
Provider Mailing Phone/Fax
| Phone: | 9093354131 |
| Fax: |