Individual
BETH L TACCA
Active
Individual
BETH L TACCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
543658-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
304642
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028045601
UNIVERA
NY
01
—
000529289001
BLUE CROSS
NY
05
—
02892822
—
NY
01
—
9514256
INDEPENDENT HEALTH
NY
Enumeration date
05/31/2007
Last updated
03/10/2008
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