Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JERRY LAN TUCKER, RDN
ActiveOncology Nutrition · ALBUQUERQUE, NM
Registration Details
- NPI Number
- 1952095556
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 6, 2023 (2.8772837783098 yrs)
- Last Updated
- Jun 6, 2023
- License
-
LD2023084 (NM)
Practice Information
- Address
-
715 DR MARTIN LUTHER KING JR AVE NE STE 102ALBUQUERQUE, NM, 871023666Browse NM providers · Browse ZIP 87102
- Phone
- 5057273028
- Primary Specialty
-
Oncology Nutrition
133VN1301X
Other Oncology Nutrition Providers in ALBUQUERQUE, NM
| Name | Credential | NPI |
|---|---|---|
| MRS. KELLY M DUNN | BS, LD, RDN, CNSC | 1952783540 |
| ERNESTINE R TRUJILLO | MS, RD, LD | 1831733757 |
| WANDA JEAN MATUSZAK | MS,RD,LD,CNSC | 1366308009 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.