Provider Demographics
NPI:1225465099
Name:BENOIT, LAURIE A (NP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:A
Last Name:BENOIT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 COREY COLONIAL
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-2746
Mailing Address - Country:US
Mailing Address - Phone:413-537-1267
Mailing Address - Fax:
Practice Address - Street 1:627 RANDALL RD
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1085
Practice Address - Country:US
Practice Address - Phone:413-858-0336
Practice Address - Fax:413-589-0912
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN206945363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology