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

Tierra Pettway

Individual provider Licensed Practical Nurse · NPI 1073491783

Tierra Pettway is a Licensed Practical Nurse in Patchogue, New York. Licensed in New York. Registered with an NPI since 2025.

Licensed in
NY
In the registry since
2025

Practice location Address checks out

53 Academy St
Patchogue, NY 11772-3821
Phone: (516) 410-4896
Show map & directions

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

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 292164 (NY)

Record details

NPI number1073491783
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 22, 2025
Last updated in NPPESAugust 22, 2025
Certification dateAugust 22, 2025

Other providers in Patchogue