Individual
TANYA LYNN PETACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1290 BLAKESLEE BOULEVARD DR W STE 1, LEHIGHTON, PA 18235-9352
(484) 934-1155
(484) 727-9991
Mailing address
1290 BLAKESLEE BOULEVARD DR W STE 1, LEHIGHTON, PA 18235-9352
(484) 934-1155
(484) 727-9991
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SPO33194
PA
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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