Provider Demographics
NPI:1386278851
Name:PRUNYI, MEGAN NICOLE (APRN, CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:NICOLE
Last Name:PRUNYI
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 LAKE HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5222
Mailing Address - Country:US
Mailing Address - Phone:077-672-4774
Mailing Address - Fax:
Practice Address - Street 1:846 LAKE HOWELL RD
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5222
Practice Address - Country:US
Practice Address - Phone:407-767-2477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner