Provider Demographics
NPI:1942074448
Name:PUNCHARD, ANTHONY MARK (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MARK
Last Name:PUNCHARD
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7055
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89510-7055
Mailing Address - Country:US
Mailing Address - Phone:352-283-1391
Mailing Address - Fax:
Practice Address - Street 1:360 MORAN ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1814
Practice Address - Country:US
Practice Address - Phone:352-283-1391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV871825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily