Provider Demographics
NPI:1356990261
Name:BURY, CHANTZ (PMHNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:CHANTZ
Middle Name:
Last Name:BURY
Suffix:
Gender:
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 MCLAWS CIR STE 3
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6346
Mailing Address - Country:US
Mailing Address - Phone:757-585-3010
Mailing Address - Fax:
Practice Address - Street 1:354 MCLAWS CIR STE 3
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6346
Practice Address - Country:US
Practice Address - Phone:757-585-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178195363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily