National Provider Identifier

Beth L Tacca, ANP

Beth L Tacca, ANP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Amherst, NY and a listed phone number of (716) 446-1435.

NPI 1962603316Amherst, NYAdult Health Nurse Practitioner

Profile Overview

NPI
1962603316
Provider Type
Individual
Primary Specialty
Adult Health Nurse Practitioner
Enumeration Date
May 31, 2007
Last Updated
March 10, 2008

Practice Location

  • 760 Millersport Hwy
  • Amherst, NY 14226-2410

Phone: (716) 446-1435

Mailing Address

  • 22 Westwood Dr
  • Tonawanda, NY 14150-5524

Specialties

  • Adult Health Nurse Practitioner (363LA2200X)
  • Registered Nurse (163W00000X)
Full Record
NPI
1962603316
Entity Type
Individual
Last Name
Tacca
First Name
Beth
Middle Name
L
Credential
ANP
Provider Other Last Name
Divietro
Provider Other First Name
Beth
Provider Other Middle Name
L
Provider Other Credential Text
ANP
Provider Other Last Name Type Code
1
Mailing Street Address
22 Westwood Dr
Mailing City
Tonawanda
Mailing State
NY
Mailing ZIP Code
14150-5524
Mailing Country
US
Mailing Phone
(716) 308-6885
Practice Street Address
760 Millersport Hwy
Practice City
Amherst
Practice State
NY
Practice ZIP Code
14226-2410
Practice Country
US
Practice Phone
(716) 446-1435
Practice Fax
(716) 446-1569
Enumeration Date
May 31, 2007
Last Updated
March 10, 2008
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Adult Health Nurse Practitioner (363LA2200X), Registered Nurse (163W00000X)
Other Identifiers
00028045601 (NY, Univera), 9514256 (NY, Independent Health), 000529289001 (NY, Blue Cross), 02892822 (NY)