Provider Demographics
NPI:1053549493
Name:RUCKER, ALETHEA YVETTE (MD)
Entity type:Individual
Prefix:DR
First Name:ALETHEA
Middle Name:YVETTE
Last Name:RUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALETHEA
Other - Middle Name:YVETTE
Other - Last Name:BARRINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:515 THOMPSON STREET
Practice Address - Street 2:SUITE D
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288
Practice Address - Country:US
Practice Address - Phone:336-627-5178
Practice Address - Fax:336-627-0727
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01391207Q00000X
NC2014 01391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine