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General NPI Number Information
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NPI Number | 1124647250
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Entity Type | Individual
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Provider Name | LAURA CHRISTINA BENEDIT NP
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Gender | Female
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 1405 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-8633
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Country | US
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Telephone | 404-785-6141
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 WINDY HILL RD SE STE 104
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City | MARIETTA
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State | GA
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Zip | 30067-8633
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | RN235040
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN235040
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License Number State | GA
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