Provider Demographics
NPI:1164025086
Name:BARRETT, BENITA F (RN)
Entity Type:Individual
Prefix:
First Name:BENITA
Middle Name:F
Last Name:BARRETT
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 1:355 CORNERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1165
Mailing Address - Country:US
Mailing Address - Phone:513-571-8960
Mailing Address - Fax:
Practice Address - Street 1:355 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1165
Practice Address - Country:US
Practice Address - Phone:513-571-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN304776163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse