| Doctor Name: | SARAH TUCKER |
| NPI Number: | 1497140917 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP |
| License Number: | 2015009464 |
| Business Practice Address: | 1000 Edgewater Pointe Ste 200 Lake St Louis, MO - 63367 |
| Business Phone Number: | 6365618088 |
| Business Fax Number: | 6365611405 |
| Mailing Address: | 1000 Edgewater Pointe, Suite 200 LAKE ST LOUIS |
| State: | MO |
| Postal Code: | 63367 |
| Phone Number: | 6365618088 |
| Fax Number: | 6365611405 |
| NPI Enumeration Date: | 04/01/2015 |
| NPI Last Update Date: | 12/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 2015009464 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |