Individual
ELIZABETH A PETCOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
252 S 4TH ST, LEBANON, PA 17042-6111
(717) 270-4876
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-4051
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
SP017652
PA
363L00000X
Nurse Practitioner
Primary
SP017652
PA
363LF0000X
Family Nurse Practitioner
MC4527581
PA
Other
Enumeration date
08/17/2017
Last updated
11/07/2025
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