Provider Demographics
NPI:1508098856
Name:BENOIT, APRIL DESIREE (RN, CNP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:DESIREE
Last Name:BENOIT
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:THEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3365 S 103RD ST
Mailing Address - Street 2:PEDIATRIC ORTHOPAEDIC SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-4161
Mailing Address - Country:US
Mailing Address - Phone:414-604-7501
Mailing Address - Fax:414-604-7506
Practice Address - Street 1:3365 S 103RD ST
Practice Address - Street 2:PEDIATRIC ORTHOPAEDIC SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4161
Practice Address - Country:US
Practice Address - Phone:414-604-7501
Practice Address - Fax:414-604-7506
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-171072-6363LP0200X
WI194074363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1508098856Medicaid