| Doctor Name: | MS. SHAMEKIA TUCKER |
| NPI Number: | 1073978672 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN214341 |
| Business Practice Address: | 7810 Highway 85 Riverdale, GA - 302743920 |
| Business Phone Number: | 7704737833 |
| Business Fax Number: | |
| Mailing Address: | 7810 Highway 85, RIVERDALE |
| State: | GA |
| Postal Code: | 302743920 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/24/2015 |
| NPI Last Update Date: | 12/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN214341 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |