Provider Demographics
NPI:1427561943
Name:RUNNELS, MEGHAN BLISS
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:BLISS
Last Name:RUNNELS
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 1:4217 LONGFELLOW DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-1260
Mailing Address - Country:US
Mailing Address - Phone:601-917-7000
Mailing Address - Fax:
Practice Address - Street 1:1001 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5721
Practice Address - Country:US
Practice Address - Phone:405-921-2841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000204426163W00000X
KY3011986367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse