Provider Demographics
NPI:1619867298
Name:CHUNG, BRYAN OLIVER (NP, RN)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:OLIVER
Last Name:CHUNG
Suffix:
Gender:M
Credentials:NP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13175 MARINA WAY APT 128
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-1250
Mailing Address - Country:US
Mailing Address - Phone:240-715-7485
Mailing Address - Fax:
Practice Address - Street 1:13175 MARINA WAY APT 128
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-1250
Practice Address - Country:US
Practice Address - Phone:240-715-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program