Provider Demographics
NPI:1437692381
Name:BENEFIELD, KRISTIN SEALS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:SEALS
Last Name:BENEFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 MAUSER CT
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-3293
Mailing Address - Country:US
Mailing Address - Phone:706-301-9222
Mailing Address - Fax:
Practice Address - Street 1:78 MAUSER CT
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-3293
Practice Address - Country:US
Practice Address - Phone:706-301-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-27
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN190477363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care