Provider Demographics
NPI:1326182312
Name:BENVIE, RUTH HAYES (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:HAYES
Last Name:BENVIE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SACHEM ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:E BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1954
Mailing Address - Country:US
Mailing Address - Phone:508-378-1423
Mailing Address - Fax:
Practice Address - Street 1:35 SUMMER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3469
Practice Address - Country:US
Practice Address - Phone:508-824-4874
Practice Address - Fax:508-823-2990
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127379367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA0260Medicare ID - Type Unspecified