Healthcare Provider Details

I. General information

NPI: 1255946547
Provider Name (Legal Business Name): CHRISTABEL BENG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2020
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6945 ELLEN BOAT LN
CANAL WNCHSTR OH
43110-7913
US

IV. Provider business mailing address

6945 ELLEN BOAT LN
CANAL WNCHSTR OH
43110-7913
US

V. Phone/Fax

Practice location:
  • Phone: 301-283-7837
  • Fax:
Mailing address:
  • Phone: 301-283-7837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN526105
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: