Provider Demographics
NPI:1861773525
Name:BRAY, RHONDA L (RN)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:L
Last Name:BRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 EXECUTIVE BLVD # 670
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4920
Mailing Address - Country:US
Mailing Address - Phone:202-505-1052
Mailing Address - Fax:
Practice Address - Street 1:6116 EXECUTIVE BLVD # 670
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4920
Practice Address - Country:US
Practice Address - Phone:202-505-1052
Practice Address - Fax:202-280-1457
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246W00000X
DCRN1007225374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
No246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology