Patricia Ann Tucker, RDN IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-35277 Issued in MI

Practice address

4490 Bonanza Dr NE
Grand Rapids, MI 49525-6848

Phone

(616) 481-7563

NPI assigned

Apr 24, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461456000000",
    "number": "1457706707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 BONANZA DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256848",
            "telephone_number": "616-481-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 BONANZA DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256848",
            "telephone_number": "616-481-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "RDN IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-24",
        "last_updated": "2016-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "660207",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "MI",
            "license": "L-35277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Catherine Tucker, PA
• Katherine E Tucker, LMSW
• Kimberly J Tucker, PT
• Madison Tucker
• Pamela Tucker
• Sara Ann Tucker, LLP
• Sheryl Lynn Tucker, RDH
• Candice Tudor
• Elizabeth Tuffelmire
• Sydney Tuggle

• Lactation Consultant (Non-RN) in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Lactation Consultant (Non-RN) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2016; 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.