Provider Demographics
NPI:1245742725
Name:BUKENYA, JUANITA ROSE (BSPHARM, PHARMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:ROSE
Last Name:BUKENYA
Suffix:
Gender:F
Credentials:BSPHARM, PHARMD, MS
Other - Prefix:DR
Other - First Name:JUANITA
Other - Middle Name:ROSE
Other - Last Name:BUKENYA-LWANGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSPHARM, PHARMD, MS
Mailing Address - Street 1:43000 ROSEMOUNT WOODS TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7550
Mailing Address - Country:US
Mailing Address - Phone:404-723-1153
Mailing Address - Fax:
Practice Address - Street 1:43000 ROSEMOUNT WOODS TER
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-7550
Practice Address - Country:US
Practice Address - Phone:404-723-1153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00069491333600000X
VA0202013137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No333600000XSuppliersPharmacy