Laura A Tucker, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2582033 Issued in WI

Practice address

West Pavilion 2 Floor
130 Second Street
Neenah, WI 54956-2753

Phone

(920) 725-9373

Fax

(920) 720-7392

NPI assigned

Sep 22, 2005

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 names 1

• Laura A Balliet Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902892243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE NEUROSCIENCE GROUP OF NE WI",
            "address_2": "WEST PAVILION 2ND FLOOR, 130 SENCOND STREET",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562753",
            "telephone_number": "920-725-9373",
            "fax_number": "920-720-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEST PAVILION 2 FLOOR",
            "address_2": "130 SECOND STREET",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562753",
            "telephone_number": "920-725-9373",
            "fax_number": "920-720-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "LAURA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "2582033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BALLIET",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Trantow, PHARMD
• James Travis, M.S.W, B.S.
• Paul F Treder, APNP
• Kimberly Kaye Trickey, LPC
• Stephanie Tsoris
• Turning the Paige Therapy, LLC
• Tiffany Jean Tweedy, DDS
• Timothy Stephan Tweedy, DDS
• Kristine Anne Twomey, APNP
• Venkata Udayagiri

• Nurse Practitioner in Neenah, WI
• Providers in Neenah, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.