Terry M Tuck, NP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024067536 Issued in VA

Practice address

2820 Normandy Dr
Petersburg, VA 23805-9372

Phone

(804) 504-8764

Fax

(804) 504-8845

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1780800300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5342 AUTUMNLEAF DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232342806",
            "telephone_number": "804-504-8764",
            "fax_number": "804-504-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 NORMANDY DR",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059372",
            "telephone_number": "804-504-8764",
            "fax_number": "804-504-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK",
        "first_name": "TERRY",
        "middle_name": "M",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024067536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER IDENTIFIER",
            "identifier": "C10279 00X494N13",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.