Provider Demographics
NPI:1528618006
Name:FUNKE, RONNIE FRANCES (NP-C)
Entity type:Individual
Prefix:MRS
First Name:RONNIE
Middle Name:FRANCES
Last Name:FUNKE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 GETTYSBURG WAY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1815
Mailing Address - Country:US
Mailing Address - Phone:862-777-2349
Mailing Address - Fax:
Practice Address - Street 1:105 RAIDER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1528
Practice Address - Country:US
Practice Address - Phone:908-281-0221
Practice Address - Fax:908-281-0890
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14298100163W00000X
NJ26NJ00976800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse