Provider Demographics
NPI:1568961456
Name:REYNOLDS, TAMEKA RUCKS (NP)
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:RUCKS
Last Name:REYNOLDS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:TAMEKA
Other - Middle Name:MICHELLE
Other - Last Name:RUCKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21004 E QUINCY PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3805
Mailing Address - Country:US
Mailing Address - Phone:912-414-1480
Mailing Address - Fax:
Practice Address - Street 1:14001 E ILIFF AVE FL 4
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1405
Practice Address - Country:US
Practice Address - Phone:912-414-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203695363L00000X
AL1-165183363L00000X
COC-APN.0102661-C-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner