Healthcare Provider Details

I. General information

NPI: 1447312897
Provider Name (Legal Business Name): RAMONA ANN BENKERT PHD, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 ANTHONY WAYNE DR SUITE 115
DETROIT MI
48202-3945
US

IV. Provider business mailing address

11124 N BECK RD
PLYMOUTH MI
48170-3327
US

V. Phone/Fax

Practice location:
  • Phone: 131-357-7504
  • Fax:
Mailing address:
  • Phone: 173-445-5854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704135899
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: