Lannette Marie Fetzer, CRNP, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Tyrone, PA
NPI 1760119614 · NPPES record last updated Aug 2, 2022
Key facts
- NPI
- 1760119614
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP021432 (PA)
- Practice address
- 4136 Green Gates LN
Tyrone, PA 16686-3032 - NPI assigned
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DLP Conemaugh Physician Practices LLC
Practice addresses (Care Compare)
105 Nason Dr
DLP Conemaugh Phys Prac LLC
Roaring Spring, PA 16673-1202
Phone (814) 224-2141
Hospital & facility affiliations
- Conemaugh Nason Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250123000214 | PA | Practitioner - Nurse Practitioner | 6800325663 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DLP Conemaugh Physician Practices LLC | Current |
Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| DLP Conemaugh Physician Practices LLC | Current | Accepting new patients | |
| DLP Conemaugh Physician Practices LLC | Current |
Accepting new patients | |
| Conemaugh Health Initiatives | Past | Accepting new patients |
Locations
600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339
1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
105 Nason Dr
Roaring Spring, PA 16673
Phone (814) 224-2141
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- lfetzer51533@direct.conemaugh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP021432 | PA | Yes |
Addresses
Primary practice location
4136 Green Gates LN
Tyrone, PA 16686-3032
Mailing address
4136 Green Gates LN
Tyrone, PA 16686-3032
Phone (814) 880-8506
Other practice location 1
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 2
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 3
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 4
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 5
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 6
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 7
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 8
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 9
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 10
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 11
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 12
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 13
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 14
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 15
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other practice location 16
4136 Green Gates Ln
Tyrone, PA 16686-3032
Other providers in Tyrone, PA
- Earthwind Medical Co, LLC
- Aubrey Patricia Edevane
- Wendy Diane Edwards
- Epworth Rehabilitation and Healthcare LLC
- William Max Faust Jr.
- Christina L Finochio
- Alexandria Franko
- Kimberly Eve Freet
- Gregg D Fuoss
- Wesley Allen Furry
All providers in Tyrone, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.