Provider Demographics
NPI:1497439566
Name:FITZ, TAMICA
Entity Type:Individual
Prefix:
First Name:TAMICA
Middle Name:
Last Name:FITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 FRASER FIR CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3426
Mailing Address - Country:US
Mailing Address - Phone:804-299-6913
Mailing Address - Fax:
Practice Address - Street 1:1800 SUMMIT AVE STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4314
Practice Address - Country:US
Practice Address - Phone:804-876-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)