=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740866102
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TONYA RENEE POORE FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2021
-----------------------------------------------------
Last Update Date | 12/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 GUTHRIE SQ
-----------------------------------------------------
City | SAYRE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18840-1625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-887-2289
-----------------------------------------------------
Fax | 570-887-2290
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 GUTHRIE SQ
-----------------------------------------------------
City | SAYRE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18840-1625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-888-5858
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1033097
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | SP034115
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 63708
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------