Healthcare Provider Details

I. General information

NPI: 1669383295
Provider Name (Legal Business Name): CARIE BENOIT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58177 VAN DYKE RD STE 103
WASHINGTON MI
48094-2767
US

IV. Provider business mailing address

47355 BLUERIDGE DR
MACOMB MI
48044-2734
US

V. Phone/Fax

Practice location:
  • Phone: 586-422-1050
  • Fax:
Mailing address:
  • Phone: 586-242-3140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704229576
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: