Provider Demographics
NPI:1164016622
Name:BENSON, MARIA GRACIELA (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GRACIELA
Last Name:BENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 LEE ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1306
Mailing Address - Country:US
Mailing Address - Phone:508-450-9327
Mailing Address - Fax:
Practice Address - Street 1:42 CAPE RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3292
Practice Address - Country:US
Practice Address - Phone:800-853-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2325146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse