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General NPI Number Information
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NPI Number | 1417778010
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Entity Type | Individual
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Provider Name | GIANNA ROSE BENEVIDES ACNPC-AG
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Gender | Female
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 41 MALL RD
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City | BURLINGTON
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State | MA
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Zip | 01805-0001
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Country | US
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Telephone | 781-744-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24520
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City | NEW YORK
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State | NY
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Zip | 10087-3720
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Country | US
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Telephone | 781-744-8085
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN2371853
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License Number State | MA
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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 | RN2371853
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License Number State | MA
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