Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Takara Leeann Muncy

Individual provider Family Nurse Practitioner · NPI 1114671906

Takara Leeann Muncy is a Nurse Practitioner in Logan, West Virginia. Qualified in 2021, 5 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
5
Licensed in
WV
In the registry since
2022
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Practice location Address checks out

174 Lmah Center Rd
Logan, WV 25601-4058
Phone: (304) 792-7130
Fax: (304) 792-7146
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 112055 (WV)

Record details

NPI number1114671906
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 9, 2022
Last updated in NPPESMarch 21, 2022
Certification dateMarch 21, 2022
Mailing address174 Lmah Center Rd, Logan, WV 25601-4058

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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