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NPI Code Detail

MEDICARE: MRS. SUSAN N BENWARE NP

MEDICARE: MRS. SUSAN N BENWARE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner141696NC

General Provider Information

NPI Number : 1366448201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN N BENWARE NP
Provider Business Mailing Address
First Line : 816 MERRY ST
Second Line :
City : DUNN
State : NC
Zip : 28334-2200
Country : US
Telephone Number : 910-892-2419
Fax Number :
Provider Business Practice Location Address
First Line : 2300 RAMSEY ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-3856
Country : US
Telephone Number : 910-488-2120
Fax Number : 910-482-5174
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 07/08/2007

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