Beverly Anne Tucker, LPN, LMT

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN 5175827 Issued in FL

Practice address

520 SW Beauford PL
Lake City, FL 32024-5244

Phone

(386) 752-3332

Fax

(386) 752-3332

NPI assigned

Mar 27, 2009

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1972745669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SW BEAUFORD PL",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320245244",
            "telephone_number": "386-752-3332",
            "fax_number": "386-752-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SW BEAUFORD PL",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320245244",
            "telephone_number": "386-752-3332",
            "fax_number": "386-752-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BEVERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LPN, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN 5175827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE BOARD",
            "identifier": "PN 5175827",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Triangle Urology Care
• Jennifer Troiano, L.M.T.
• J Anthony Trott, M.D.
• Tru' Concierge Care, LLC
• Tucker & Co. LLC
• Rachel Lauren Tucker, DNP
• Richard Lamar Tucker
• Krishnarao V Tummala, MD
• Sheritia Tunsil
• Dwayne Turner

• Licensed Practical Nurse in Lake City, FL
• Providers in Lake City, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.