Provider Demographics
NPI:1710213830
Name:BENEKER-EMERICK, AMY MACHIEL (LPN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MACHIEL
Last Name:BENEKER-EMERICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8158 SLATE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-4911
Mailing Address - Country:US
Mailing Address - Phone:614-595-3096
Mailing Address - Fax:
Practice Address - Street 1:8158 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4911
Practice Address - Country:US
Practice Address - Phone:614-595-3096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 134809164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse