Provider Demographics
NPI:1710742937
Name:HRICIK, TANYA M (CRNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:M
Last Name:HRICIK
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 1:1097 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1465
Mailing Address - Country:US
Mailing Address - Phone:272-639-5650
Mailing Address - Fax:272-639-5651
Practice Address - Street 1:1097 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1465
Practice Address - Country:US
Practice Address - Phone:272-639-5650
Practice Address - Fax:272-639-5651
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028454363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner