Provider Demographics
NPI:1487376190
Name:TUCKER, ALISHA MONIQUE
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:MONIQUE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 N MILITARY HWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3794
Mailing Address - Country:US
Mailing Address - Phone:904-382-8091
Mailing Address - Fax:
Practice Address - Street 1:260 MARCELLA RD APT 519
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2594
Practice Address - Country:US
Practice Address - Phone:904-382-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula