Provider Demographics
NPI:1649270315
Name:KAEFER, TANA NECSARY (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:TANA
Middle Name:NECSARY
Last Name:KAEFER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 STAPLES MILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3109
Mailing Address - Country:US
Mailing Address - Phone:804-285-8055
Mailing Address - Fax:804-285-8059
Practice Address - Street 1:2002 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3109
Practice Address - Country:US
Practice Address - Phone:804-285-8055
Practice Address - Fax:804-285-8059
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist