Provider Demographics
NPI:1861774069
Name:MENNS, TANYA ANN-MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ANN-MARIE
Last Name:MENNS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ROUNTREE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7084
Mailing Address - Country:US
Mailing Address - Phone:757-580-4835
Mailing Address - Fax:757-546-8749
Practice Address - Street 1:321 BATTLEFIELD BLVD S
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5311
Practice Address - Country:US
Practice Address - Phone:757-546-8683
Practice Address - Fax:757-546-8749
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist