Provider Demographics
NPI:1689385544
Name:BENKELMAN, SAMIE JO (RN)
Entity Type:Individual
Prefix:
First Name:SAMIE
Middle Name:JO
Last Name:BENKELMAN
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 1:8940 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-9605
Mailing Address - Country:US
Mailing Address - Phone:585-322-2943
Mailing Address - Fax:
Practice Address - Street 1:8940 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-9605
Practice Address - Country:US
Practice Address - Phone:585-322-2943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY698988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse