Provider Demographics
NPI:1487267415
Name:TUCKER, ALETHEA HOPE (NP)
Entity type:Individual
Prefix:
First Name:ALETHEA
Middle Name:HOPE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 EXCHANGE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:GA
Mailing Address - Zip Code:30620-1797
Mailing Address - Country:US
Mailing Address - Phone:678-250-0880
Mailing Address - Fax:
Practice Address - Street 1:3685 BRASELTON HWY STE 100
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-5920
Practice Address - Country:US
Practice Address - Phone:678-250-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285714363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care