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General NPI Number Information
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NPI Number | 1699620187
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Entity Type | Individual
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Provider Name | JAMAICA BENTON CNA
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 6470 E JOHNS XING STE 160
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City | JOHNS CREEK
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State | GA
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Zip | 30097-1500
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Country | US
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Telephone | 770-912-1317
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Fax |
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Provider Business Mailing Address
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Address Line | 3511 RUBEN ST
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City | COLUMBUS
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State | GA
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Zip | 31906-3447
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Country | US
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Telephone | 706-577-9009
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | CN0028835752
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License Number State | GA
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