Provider Demographics
NPI:1639270150
Name:GRUENBERG, BONNIE URQUHART (RN CNM CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:URQUHART
Last Name:GRUENBERG
Suffix:
Gender:F
Credentials:RN CNM CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PINETREE DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANNON
Mailing Address - State:PA
Mailing Address - Zip Code:17020-7114
Mailing Address - Country:US
Mailing Address - Phone:717-834-5322
Mailing Address - Fax:
Practice Address - Street 1:423 N 21ST ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2207
Practice Address - Country:US
Practice Address - Phone:717-763-9880
Practice Address - Fax:717-737-2765
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009444363LW0102X
PARN358895L364SW0102X
PAMW010040367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
069593E6TMedicare ID - Type Unspecified