Provider Demographics
NPI:1548440886
Name:TUCKER, CHERYL LYNN (ND DHOM)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LYNN
Last Name:TUCKER
Suffix:
Gender:F
Credentials:ND DHOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 E 100 S
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-9614
Mailing Address - Country:US
Mailing Address - Phone:317-769-5263
Mailing Address - Fax:317-769-5265
Practice Address - Street 1:6200 E 100 S
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-9614
Practice Address - Country:US
Practice Address - Phone:317-769-5263
Practice Address - Fax:317-769-5265
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNAT226175F00000X, 175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath