Healthcare Provider Details

I. General information

NPI: 1912360181
Provider Name (Legal Business Name): MICHELLE MUNSON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE MURPHY RN

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 05/12/2025
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HOSPITAL RD SUITE 111
PRINCE FREDERICK MD
20678
US

IV. Provider business mailing address

110 HOSPITAL RD SUITE 111
PRINCE FREDERICK MD
20678
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-4488
  • Fax: 443-771-8114
Mailing address:
  • Phone: 410-535-4488
  • Fax: 443-771-8114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR170125
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: