| Doctor Name: | MRS. CAROLINE CRUZ BODNER |
| NPI Number: | 1063548477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ACNP |
| License Number: | R136960 |
| Business Practice Address: | 7600 Carroll Ave Unit 2500 Np Office Takoma Park, MD - 209126367 |
| Business Phone Number: | 3018917600 |
| Business Fax Number: | 3018915354 |
| Mailing Address: | 768 College Pkwy, ROCKVILLE |
| State: | MD |
| Postal Code: | 208501929 |
| Phone Number: | 3014245967 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | R136960 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |