Individual ProviderSylvia Tawanda RuckerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(706) 988-0862PECOS EnrollmentBased on the most recent information from CMS, provider Sylvia Tawanda Rucker does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1154718054Provider TypeIndividualFull NameRucker, Sylvia TawandaTitleMrs.CredentialFNPGenderFemaleSole ProprietorYesEnumeration Date4/20/2015Last Updated9/14/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(706) 988-0862FaxUnlisted FaxMailing LocationMailing Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(706) 988-0862FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN182996Georgia