Provider Demographics
NPI:1659951580
Name:GARRETT, BENITHA SEBRINA (RN)
Entity Type:Individual
Prefix:
First Name:BENITHA
Middle Name:SEBRINA
Last Name:GARRETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5592 BROADVIEW RD STE 107
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-7811
Mailing Address - Country:US
Mailing Address - Phone:216-965-5040
Mailing Address - Fax:216-744-2544
Practice Address - Street 1:5592 BROADVIEW RD STE 107
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-7811
Practice Address - Country:US
Practice Address - Phone:216-965-5040
Practice Address - Fax:216-744-2544
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN253537163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health