Provider Demographics
NPI:1093540635
Name:TUCKER, ASHLEY MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2983 HALEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41004-8761
Mailing Address - Country:US
Mailing Address - Phone:606-782-6888
Mailing Address - Fax:
Practice Address - Street 1:2983 HALEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41004-8761
Practice Address - Country:US
Practice Address - Phone:606-782-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4025559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily