Individual provider Active NPI

Treasa Tucker

  • Long-Term Care Clinical Nurse Specialist
  • Martinsville, IN
National Provider Identifier
1407424997
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long-Term Care Clinical Nurse SpecialistTaxonomy code 364SL0600X
License
28222410A Issued in IN
Practice address
170 E Maple Turn Rd
Martinsville, IN 46151-8040
Phone
(317) 440-7261
NPI assigned
Jun 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long-Term Care Clinical Nurse Specialist 364SL0600X 28222410A IN Primary

Addresses

Primary practice location

170 E Maple Turn Rd
Martinsville, IN 46151-8040

Mailing address

170 E Maple Turn Rd
Martinsville, IN 46151-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28222410AINMDLong-Term Care Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1407424997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E MAPLE TURN RD",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461518040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 E MAPLE TURN RD",
            "city": "MARTINSVILLE",
            "state": "IN",
            "postal_code": "461518040",
            "telephone_number": "317-440-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TREASA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SL0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Long-Term Care",
            "state": "IN",
            "license": "28222410A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.