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Takara Leeann Muncy
Family Nurse Practitioner in Logan, West Virginia
NPI 1114671906

Takara Leeann Muncy is a Family Nurse Practitioner based in Logan, WV and is specialized in Family. Takara Leeann Muncy practices in Logan, WV. The NPI Number for Takara Leeann Muncy is 1114671906 and holds a License No. 112055 (West Virginia).

The current practice location address for Takara Leeann Muncy is 174 Lmah Center Rd, Logan, WV and can be reached out via phone at 304-792-7130 and via fax at 304-792-7146.

Location: 174 Lmah Center Rd, Logan, WV, 25601-4058
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114671906
Provider Name
Takara Leeann Muncy
Credential
Provider Entity Type
Individual
Gender
Female
Address
174 Lmah Center Rd, Logan, WV, 25601-4058
Phone Number
304-792-7130
Fax Number
304-792-7146
Provider Enumeration Date
02/09/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
174 Lmah Center Rd
City
Logan
State
West Virginia
Zip
25601-4058
Phone Number
304-792-7130
Fax Number
304-792-7146
person
Provider Business Mailing Address Details
Address
174 Lmah Center Rd
City
Logan
State
West Virginia
Zip
25601-4058
Phone Number
304-792-7130
Fax Number
304-792-7146
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
112055 (West Virginia)
Definition
Definition to come...
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