MEDICARE: KARLA LUNDY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	32055	SC
2	363LF0000X	Family Nurse Practitioner	025902	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F08190304	OTHER		NP CERT NUMBER

General Provider Information

NPI Number	:	1487298279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA LUNDY NP

Provider Business Mailing Address
First Line	:	PO BOX 740003
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-0003
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	1735 HECKLE BLVD UNIT M-S130
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-4803
Country	:	US
Telephone Number	:	803-659-3444
Fax Number	:	803-306-6679

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	06/15/2026

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