Provider Demographics
NPI:1518573443
Name:BENAVIDES, ELIZABETH DANIELLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DANIELLE
Last Name:BENAVIDES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 N INTERSTATE 35
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7220
Mailing Address - Country:US
Mailing Address - Phone:361-960-3818
Mailing Address - Fax:
Practice Address - Street 1:1509 N INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7220
Practice Address - Country:US
Practice Address - Phone:361-960-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
TX1010547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care