Basic Information
Provider Information
NPI: 1669721023
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JUNGERMANN
FirstName: ABBIE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FRANKART
OtherFirstName: ABBIE
OtherMiddleName: LYNN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2 CATHARINE STREET
Address2: MID-HUDSON ANESTHESIOLOGISTS, PC
City: POUGHKEEPSIE
State: NY
PostalCode: 12602
CountryCode: US
TelephoneNumber: 8668852318
FaxNumber: 8457902675
Practice Location
Address1: 70 DUBOIS STREET
Address2: ST LUKES/ CORNWALL HOSPITAL
City: NEWBURGH
State: NY
PostalCode: 12550
CountryCode: US
TelephoneNumber: 8455614400
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2012
LastUpdateDate: 05/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XR200409MDN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000X618232-1NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home