Healthcare Provider Details

I. General information

NPI: 1861915779
Provider Name (Legal Business Name): MEGAN KARIN TYNDALL FNP-C, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN KARIN PUSEY RN

II. Dates (important events)

Enumeration Date: 07/23/2017
Last Update Date: 07/24/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9950 MAIN ST
BERLIN MD
21811
US

IV. Provider business mailing address

7903 QUEPONCO RD
NEWARK MD
21841-2333
US

V. Phone/Fax

Practice location:
  • Phone: 410-912-6710
  • Fax:
Mailing address:
  • Phone: 302-858-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR235984
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR235984
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: