Healthcare Provider Details

I. General information

NPI: 1881542157
Provider Name (Legal Business Name): BENJAMIN ALAN HERMONAT PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 RANDALL PKWY
WILMINGTON NC
28403-2829
US

IV. Provider business mailing address

330 SUMMERHOUSE DR
HOLLY RIDGE NC
28445-6003
US

V. Phone/Fax

Practice location:
  • Phone: 540-492-1348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5024477
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: