Healthcare Provider Details

I. General information

NPI: 1851794747
Provider Name (Legal Business Name): MEGAN TUMULTY NP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 RIVA RD
ANNAPOLIS MD
21401-7305
US

IV. Provider business mailing address

1533 WIDOWS MITE RD
EDGEWATER MD
21037-2144
US

V. Phone/Fax

Practice location:
  • Phone: 208-724-3403
  • Fax:
Mailing address:
  • Phone: 208-724-3403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR273910
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR273910
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: