Provider Demographics
NPI:1487418109
Name:CUNNINGHAM, MEGHAN CHELLMAN (APRN)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:CHELLMAN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:MARTHEA
Other - Last Name:CHELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2917 QUAIL RISE CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-6300
Mailing Address - Country:US
Mailing Address - Phone:850-545-0385
Mailing Address - Fax:
Practice Address - Street 1:2917 QUAIL RISE CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-6300
Practice Address - Country:US
Practice Address - Phone:850-545-0385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily