Provider Demographics
NPI:1659805448
Name:FLOUNDERS, BENJAMIN DANIEL (RN)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:DANIEL
Last Name:FLOUNDERS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:DANIEL
Other - Last Name:FLOUNDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:700 MILFORD CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-5808
Mailing Address - Country:US
Mailing Address - Phone:864-607-5627
Mailing Address - Fax:
Practice Address - Street 1:700 MILFORD CHURCH RD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5808
Practice Address - Country:US
Practice Address - Phone:864-607-5627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC206070163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse