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General NPI Number Information
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NPI Number | 1063548477
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Entity Type | Individual
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Provider Name | CAROLINE CRUZ BODNER ACNP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVENUE CARDIOLOGY BUILDING 9
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City | BETHESDA
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State | MD
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Zip | 20889-6367
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Country | US
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Telephone | 301-319-2797
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Fax | 301-295-6638
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Provider Business Mailing Address
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Address Line | 768 COLLEGE PKWY
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City | ROCKVILLE
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State | MD
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Zip | 20850-1929
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Country | US
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Telephone | 301-424-5967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R136960
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License Number State | MD
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