MRS. LISA YOLANDA MOORE TUCKER FNP NPI 1679093462

NPI Information

NPI: 1679093462
Provider Name: MRS. LISA YOLANDA MOORE TUCKER, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: PRISMA HEALTH MEDICAL GROUP-MIDLANDS

PECOS Registration: Yes

Address:
2 MEDICAL PARK RD STE 506
COLUMBIA, SC
ZIP 29203
Phone: (803) 434-3930
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MRS. Lisa Yolanda Moore Tucker, FNP is a family nurse practitioner in Columbia, SC with 4 years of experience. MRS. Lisa Yolanda Moore Tucker, FNP NPI is 1679093462. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2 MEDICAL PARK RD STE 506
COLUMBIA, SC
ZIP 29203-876
Phone: (803) 434-3930
Fax: (803) 933-3035

The NPI 1679093462 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2017 and was last updated on 11/12/2021.

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
1	163WD0400X	Registered Nurse	Diabetes Educator	90318	SOUTH CAROLINA	No
2	363LF0000X	Nurse Practitioner	Family	24917	SOUTH CAROLINA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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