Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanya Marie Wagner, CRNP

Individual provider Family Nurse Practitioner · NPI 1659145480

Tanya Marie Wagner, CRNP is a Nurse Practitioner in Pine Grove, Pennsylvania. Qualified in 2023, 3 years ago. Practices with Lehigh Valley Physician Group, a 2,493-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
3
Licensed in
PA
In the registry since
2023
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

121 S Tulpehocken St
Pine Grove, PA 17963-1217
Phone: (570) 345-2345
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 — (570) 621-9270

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP029206 (PA)

Record details

NPI number1659145480
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedNovember 13, 2023
Last updated in NPPESFebruary 23, 2024
Certification dateFebruary 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Lehigh Valley Physician Group — 2493 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare