| Doctor Name: | MRS. MILDRED TUCK |
| NPI Number: | 1144364423 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | RN021526 |
| Business Practice Address: | 1608 Meadows Ln Ste 1 Vidalia, GA - 304749907 |
| Business Phone Number: | 9125379488 |
| Business Fax Number: | 9125378951 |
| Mailing Address: | 1608 Meadows Ln Ste 1, VIDALIA |
| State: | GA |
| Postal Code: | 304749907 |
| Phone Number: | 9125379488 |
| Fax Number: | 9125378951 |
| NPI Enumeration Date: | 02/19/2007 |
| NPI Last Update Date: | 12/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN021526 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |