Provider Demographics
NPI:1225685027
Name:BENOIT, CHARMALINE ZEPHIRIN (LPN)
Entity Type:Individual
Prefix:
First Name:CHARMALINE
Middle Name:ZEPHIRIN
Last Name:BENOIT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CHARMALINE
Other - Middle Name:
Other - Last Name:ZEPHIRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 EAST MONROE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869
Mailing Address - Country:US
Mailing Address - Phone:305-763-5237
Mailing Address - Fax:
Practice Address - Street 1:417 EAST MONROE STREET
Practice Address - Street 2:
Practice Address - City:NEW BREMEN
Practice Address - State:OH
Practice Address - Zip Code:45869
Practice Address - Country:US
Practice Address - Phone:305-763-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.161254.MEDS.IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse