Provider Demographics
NPI:1679836233
Name:FRUNJANG, BERNADETTE N
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:N
Last Name:FRUNJANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12139 FAWN LAKE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551
Mailing Address - Country:US
Mailing Address - Phone:301-605-4101
Mailing Address - Fax:
Practice Address - Street 1:7600 GEORGIA AVE NW
Practice Address - Street 2:SUITE 323
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-723-3060
Practice Address - Fax:202-723-3065
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1017959163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health