Provider Demographics
NPI:1447708318
Name:FLEMING, TAMARA KRANTZ (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:KRANTZ
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 ALVARADO RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4204
Mailing Address - Country:US
Mailing Address - Phone:804-334-1190
Mailing Address - Fax:804-288-7604
Practice Address - Street 1:8051 PROSPERITY WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:RUTHER GLEN
Practice Address - State:VA
Practice Address - Zip Code:22546-5812
Practice Address - Country:US
Practice Address - Phone:804-448-1380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174003363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health