Provider Demographics
NPI:1083926810
Name:BENZINGER, JENNIFER L (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BENZINGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-2817
Mailing Address - Country:US
Mailing Address - Phone:920-242-7484
Mailing Address - Fax:
Practice Address - Street 1:1117 N 8TH ST
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-2817
Practice Address - Country:US
Practice Address - Phone:920-242-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI308474-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse