Provider Demographics
NPI:1609392406
Name:BENEFIEL, DAWN LEIGHANN (APRN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:LEIGHANN
Last Name:BENEFIEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:LEIGHANN
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2200 JEFFERSON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1532 LONE OAK RD STE 310
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7942
Practice Address - Country:US
Practice Address - Phone:270-538-6200
Practice Address - Fax:270-538-6220
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011758363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology