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General NPI Number Information
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NPI Number | 1124641519
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Entity Type | Individual
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Provider Name | JULIE BENEDICT DNP, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 5225 23RD AVE S
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City | FARGO
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State | ND
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Zip | 58104-7927
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Country | US
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Telephone | 701-417-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 25TH ST S
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City | FARGO
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State | ND
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Zip | 58103-6104
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Country | US
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Telephone | 701-340-6936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R40323
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License Number State | ND
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