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General NPI Number Information
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NPI Number | 1477365898
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Entity Type | Individual
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Provider Name | DEANNA LYNN BENAVIDEZ
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Gender | Female
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1168 W MAIN ST APT 5
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City | BELLEVUE
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State | OH
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Zip | 44811-9014
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Country | US
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Telephone | 567-201-3306
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 OAK HARBOR RD LOT 52
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City | FREMONT
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State | OH
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Zip | 43420-1060
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Country | US
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Telephone | 567-201-3306
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | CNA1801057
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License Number State | IN
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