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General NPI Number Information
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NPI Number | 1790599769
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Entity Type | Individual
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Provider Name | MS. NICOLE MARIE BENJAMIN
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Gender | Female
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 10 ADAMS ST
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City | NORTH CHELMSFORD
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State | MA
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Zip | 01863-1780
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Country | US
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Telephone | 978-251-3159
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Fax |
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Provider Business Mailing Address
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Address Line | 5 LINLEW DR APT 22
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City | DERRY
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State | NH
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Zip | 03038-3044
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Country | US
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Telephone | 603-732-2609
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2378087
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN2378087
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License Number State | MA
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