Healthcare Provider Details

I. General information

NPI: 1730480773
Provider Name (Legal Business Name): LEA MARIE BENVENUTI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEA MARIE ALBERGHINI APRN

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 01/05/2024
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BACK ROAD
PLEASANT POINT ME
04667
US

IV. Provider business mailing address

PO BOX 351
PERRY ME
04667
US

V. Phone/Fax

Practice location:
  • Phone: 207-853-0644
  • Fax: 207-853-2347
Mailing address:
  • Phone: 207-853-0644
  • Fax: 207-853-2347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP211429
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: