Provider Demographics
NPI:1134671720
Name:SARGENT, TANYA JEAN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:JEAN
Last Name:SARGENT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 GLADES PIKE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1143
Mailing Address - Country:US
Mailing Address - Phone:814-445-4585
Mailing Address - Fax:
Practice Address - Street 1:4324 GLADES PIKE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501
Practice Address - Country:US
Practice Address - Phone:814-445-4584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-29
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily