Healthcare Provider Details

I. General information

NPI: 1134034366
Provider Name (Legal Business Name): STEPHANIE BENEFIELD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 COMMONS DR W STE 120
DESTIN FL
32541-8424
US

IV. Provider business mailing address

4012 COMMONS DR W STE 120
DESTIN FL
32541-8424
US

V. Phone/Fax

Practice location:
  • Phone: 850-376-5013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9620302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: