Provider Demographics
NPI:1154089514
Name:DE LEON, ANABELL BENAVIDES (FNP)
Entity Type:Individual
Prefix:
First Name:ANABELL BENAVIDES
Middle Name:
Last Name:DE LEON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANABELL
Other - Middle Name:
Other - Last Name:BENAVIDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3566 CALLE COSTA RICA
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1139
Mailing Address - Country:US
Mailing Address - Phone:956-551-7784
Mailing Address - Fax:
Practice Address - Street 1:100 E ALTON GLOOR BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3328
Practice Address - Country:US
Practice Address - Phone:956-350-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily