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NIKITA DERYABIN TUCKER
NPI 1619704152
Military Health Care Provider - Independent Duty Corpsman in Camp Lejeune, NC

Active since September 18, 2024
PSC BOX 20183, CAMP LEJEUNE, NC 28542(910) 440-7704 Get Directions Write a Review

NPPES record last updated: September 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nikita Deryabin Tucker NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NIKITA DERYABIN TUCKER (NPI 1619704152) is an individual independent duty corpsman provider in Camp Lejeune, North Carolina, licensed in North Carolina (12222246ND) and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1619704152
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameNIKITA DERYABIN TUCKER
Location AddressPSC BOX 20183Camp Lejeune, NC 28542-0183
Mailing AddressPsc Box 20183Camp Lejeune, NC 28542
Phone(910) 440-7704
Sole ProprietorNo
Enumeration DateSeptember 18, 2024
NPPES CertifiedSeptember 12, 2024
✔ NPI 1619704152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
License✔ Licensed in NC · 12222246ND
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
PSC BOX 20183, Camp Lejeune, NC 28542
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. PETER MORENO IV SOIDC
Military Health Care Provider (Independent Duty Corpsman)
PSC BOX 20183, 2D MARINE SPECIAL OPERATIONS BATTALION
CAMP LEJEUNE, NC 28542
Onslow County (910) 440-7704
FRANK ANTHONY ZAMBIK
Military Health Care Provider (Independent Duty Medical Technicians)
PSC BOX 20183
CAMP LEJEUNE, NC 28542
Onslow County (910) 440-7704

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nikita Tucker's NPI number?

The NPI number for Nikita Tucker is 1619704152. It was assigned to this individual provider in the NPPES registry on September 18, 2024.

Where is Nikita Tucker located?

Nikita Tucker practices at Psc Box 20183, Camp Lejeune, NC 28542. The listed phone number is (910) 440-7704.

What is Nikita Tucker's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Nikita Tucker was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.