Provider Demographics
NPI:1376297655
Name:BENFORD, CAMMIE (RN)
Entity Type:Individual
Prefix:
First Name:CAMMIE
Middle Name:
Last Name:BENFORD
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 1:960A HARVEST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1991
Mailing Address - Country:US
Mailing Address - Phone:267-825-0051
Mailing Address - Fax:
Practice Address - Street 1:960A HARVEST DR STE 100
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1991
Practice Address - Country:US
Practice Address - Phone:267-825-0051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN343078L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse