Provider Demographics
NPI:1750053104
Name:BENOV, DEANNA L (MBA,RN)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:L
Last Name:BENOV
Suffix:
Gender:F
Credentials:MBA,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 E ALLUVIAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2516
Mailing Address - Country:US
Mailing Address - Phone:559-905-5361
Mailing Address - Fax:
Practice Address - Street 1:951 E ALLUVIAL AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2516
Practice Address - Country:US
Practice Address - Phone:559-905-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN6801467163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator