Most Relevant Information
Provider Data
| NPI Number: | 1003390444 |
| Provider Name: | TATYANA KRYACHKOV CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | SP019246 |
Most Important Dates
| Enumeration Date: | 09/21/2018 |
| Last Updated: | 10/21/2020 |
Provider Practice Location
3250 W LAKE RD.
SUITE 2
ERIE
PA
165053691
Practice Location Phone/Fax
| Phone: | 8147904567 |
| Fax: | 8142954074 |
Provider Mailing Location
3250 W LAKE RD.
SUITE 2
ERIE
PA
165053691
Provider Mailing Phone/Fax
| Phone: | 8147904567 |
| Fax: | 8142954074 |