Provider Demographics
NPI:1386347615
Name:GRENE, TANYA (FNP)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:GRENE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20512 TODD AVE # 231
Mailing Address - Street 2:
Mailing Address - City:BATTERY PARK
Mailing Address - State:VA
Mailing Address - Zip Code:23304-1000
Mailing Address - Country:US
Mailing Address - Phone:757-524-3381
Mailing Address - Fax:
Practice Address - Street 1:12373 HORNSBY LN # 504
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-6958
Practice Address - Country:US
Practice Address - Phone:757-524-3381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186758363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner