Provider Demographics
NPI:1780838078
Name:PUNDA, MEGHAN CLAY (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:CLAY
Last Name:PUNDA
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:9160 FORUM CORPORATE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-7808
Mailing Address - Country:US
Mailing Address - Phone:239-785-3200
Mailing Address - Fax:813-630-6105
Practice Address - Street 1:6410 ROCKLEDGE DR STE 660
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1915
Practice Address - Country:US
Practice Address - Phone:301-571-0019
Practice Address - Fax:240-482-0555
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR130916363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner