Healthcare Provider Details

I. General information

NPI: 1912204678
Provider Name (Legal Business Name): BRITTNEY J BOMBERGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ROTHERMEL DR
YEAGERTOWN PA
17099-9707
US

IV. Provider business mailing address

25 ROTHERMEL DR
YEAGERTOWN PA
17099-9707
US

V. Phone/Fax

Practice location:
  • Phone: 717-248-8197
  • Fax: 717-248-6449
Mailing address:
  • Phone: 717-248-8197
  • Fax: 717-248-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN622242
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: