Provider Demographics
NPI:1972078285
Name:PAOLETTA, TRACY L (CRNP)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:L
Last Name:PAOLETTA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:L
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:724-981-1777
Mailing Address - Fax:724-342-2879
Practice Address - Street 1:62 STRAWBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3234
Practice Address - Country:US
Practice Address - Phone:724-347-2955
Practice Address - Fax:724-347-4664
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019404363LG0600X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No208800000XAllopathic & Osteopathic PhysiciansUrology