Provider Demographics
NPI:1407260565
Name:LUNGER, JARRYD D (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JARRYD
Middle Name:D
Last Name:LUNGER
Suffix:
Gender:M
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:2837 1ST AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8603
Practice Address - Country:US
Practice Address - Phone:727-334-1546
Practice Address - Fax:727-608-2974
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9382656363L00000X
MNCNP3773363LP0808X
FLAPRN9382656363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012808400Medicaid
FLHW441YMedicare PIN
FLHW441ZMedicare PIN