Provider Demographics
NPI:1467756718
Name:BENSON, TANISHA KENTA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TANISHA
Middle Name:KENTA
Last Name:BENSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 NW WASHINGTON BLVD
Mailing Address - Street 2:HAMILTON
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-1784
Mailing Address - Country:US
Mailing Address - Phone:513-207-2537
Mailing Address - Fax:
Practice Address - Street 1:1024 CHESTNUT ST
Practice Address - Street 2:HAMILTON
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3733
Practice Address - Country:US
Practice Address - Phone:513-207-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN733-105164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse