Provider Demographics
NPI:1144407883
Name:MUNSEY, MEGAN E (CRNA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:MUNSEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:MALLORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 NORTH HARRISON PKWY
Mailing Address - Street 2:SUITE 200, MAILSTOP SH 9
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-616-3879
Practice Address - Street 1:1000 MAR WALT DRIVE
Practice Address - Street 2:
Practice Address - City:FORT WALTON
Practice Address - State:FL
Practice Address - Zip Code:32547
Practice Address - Country:US
Practice Address - Phone:850-862-1111
Practice Address - Fax:954-851-1746
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-102865367500000X
FLARNP9316699367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered