Healthcare Provider Details

I. General information

NPI: 1306755889
Provider Name (Legal Business Name): MUNA KC KUNDALIA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 W MEMORIAL RD
OKLAHOMA CITY OK
73142-2026
US

IV. Provider business mailing address

16301 MONTAGUE DR
EDMOND OK
73013-9729
US

V. Phone/Fax

Practice location:
  • Phone: 405-384-5250
  • Fax:
Mailing address:
  • Phone: 405-371-3103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number231235
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: