MS. KELLIE RENEE' TUCKER (NPI# 1851541593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851541593 |
| Entity Type | Individual |
| Full Name | MS. KELLIE RENEE' TUCKER |
| Credential | PA-C |
| Practice Address |
901 N Waldron St. Arcadia FL 34266-5011 |
| Mailing Address |
901 N Waldron St Arcadia FL 34266-3541 |
| Practice Telephone | 8633034260 |
| Practice Fax Number | 8634943227 |
| Mailing Telephone | 8633034260 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2016-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9104809 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407222078 | Kellie Tucker | Counselor | 46950 Community Plz Ste 211, Sterling, VA 20164-1814 | 2015-08-18 |
| Street Address |
901 N WALDRON ST. |
| City | ARCADIA |
| State | FL |
| Zip Code | 34266-5011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578102471 | Catherine Cosgrave | Nurse Practitioner | 13619 Fl-70, Arcadia, FL 34266 | 2019-12-26 |
| 1194102285 | Catalyst Walk-in Clinic | Clinic/Center | 1707 East Oak Street, Arcadia, FL 34266 | 2015-04-28 |
| 1538562699 | Corinthia Harrison Ross | Counselor | 720 Sw Martin Luther King St, Arcadia, FL 34266 | 2014-10-03 |
| 1770983009 | Terry L Chouinard | General Acute Care Hospital | 1031 E Oak Street, Arcadia, FL 34266 | 2014-08-22 |
| 1922342336 | Ironhead Ranch, Inc. | Assisted Living Facility | 1711 Sw County Rd 760a, Arcadia, FL 34266 | 2012-11-26 |
| 1841534666 | Ironhead Ranch, Inc. | Assisted Living Facility | 2605 Sw Baldwin St, Arcadia, FL 34266 | 2012-11-16 |
| 1336499367 | Precious Angels Home Care | Home Health | 18 N Polk Ave, Arcadia, FL 34266 | 2012-09-18 |
| 1891064721 | Manatee Diagnostic Center, Ltd | Radiology | 833 N Robert Avenue, Arcadia, FL 34266 | 2011-12-21 |
| 1952547853 | Dorothy A Smith | Massage Therapist | 702 N. Robert Ave, Arcadia, FL 34266 | 2008-12-23 |
| 1851588057 | Leslie Krajcovic | Dentist | 930 E Gibson St, Arcadia, FL 34266 | 2007-10-02 |
| Find all providers in zip 34266 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356977607 | Shirin Heydari | Physician Assistant | 936 W Huntington Dr Apt G, Arcadia, CA 91007-6516 | 2020-03-18 |
| 1649804139 | Michaela Levings | Physician Assistant | 506 Columbia Rd, Arcadia, CA 91007-6207 | 2020-02-24 |
| 1043855083 | Tiffany Wang | Physician Assistant | 2031 S 8th Ave, Arcadia, CA 91006-4906 | 2019-11-13 |
| 1326378191 | Lesly Boayes | Physician Assistant | 1305 Pepper Way, Arcadia, CA 91006-6351 | 2009-12-30 |
| 1013104629 | Florin Frank Bilauca | Physician Assistant | 444 E Huntington Dr Ste 300, Arcadia, CA 91006-6258 | 2007-09-27 |
| 1881880912 | Pia Lyn Khuu | Physician Assistant | 300 West Huntington Drive, Arcadia, CA 91007-3402 | 2007-09-21 |
| 1528166014 | John Medina | Physician Assistant | 624 W Duarte Rd Ste 203, Arcadia, CA 91007-9262 | 2006-09-20 |
| 1790317022 | Elizabeth Swengros | Physician Assistant | 425 Nursing Home Dr, Arcadia, FL 34266-3839 | 2020-02-05 |
| 1194379149 | Adam Joseph Kapitz | Physician Assistant | 289 W Huntington Dr Ste 309, Arcadia, CA 91007-3493 | 2019-07-29 |
| 1235693821 | Cotton Emergency Group, LLC | Physician Assistant | 1175 Pine St Ste 200, Arcadia, LA 71001-3122 | 2019-01-28 |
| Find all providers in ARCADIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.