JERRY DEWAYNE TUCKER NPI 1407998404

NPI Information

  • NPI: 1407998404
  • Provider Name: JERRY DEWAYNE TUCKER
  • Classification: Specialist/Technologist, Pathology - 246QM0706X
  • Specialization: Medical Technologist
  • Entity Type: Individual
  • Address: US COAST GUARD SPECIAL MISSIONS TRAINING CENTER
    BB-11 COURTHOUSE BAY
    CAMP LEJEUNE, NC
    ZIP 28542
  • Phone: (910) 376-0773

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NPI Details

Jerry Dewayne Tucker is a medical technologist specialist technologist pathology in Camp Lejeune, NC. Jerry Dewayne Tucker NPI is 1407998404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

US COAST GUARD SPECIAL MISSIONS TRAINING CENTER
BB-11 COURTHOUSE BAY
CAMP LEJEUNE, NC
ZIP 28542
Phone: (910) 376-0773
Fax: (910) 450-7040

The enumeration date for this NPI number is 2/13/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1246QM0706XSpecialist/Technologist, PathologyMedical TechnologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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