Provider Demographics
NPI:1184840902
Name:BENOIT, ANDREW PAUL (FNP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:PAUL
Last Name:BENOIT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2389 HIGHWAY 28 E
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5607
Mailing Address - Country:US
Mailing Address - Phone:318-487-1925
Mailing Address - Fax:318-478-1674
Practice Address - Street 1:2389 HIGHWAY 28 E
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5607
Practice Address - Country:US
Practice Address - Phone:318-487-1925
Practice Address - Fax:318-478-1674
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08434204138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1149691Medicaid
LA1448524Medicaid