Provider Demographics
NPI:1770231250
Name:BENOIT, CASSANDRA ANN (NP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANN
Last Name:BENOIT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 JEFFERSON HWY APT 1503
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2408
Mailing Address - Country:US
Mailing Address - Phone:225-803-5356
Mailing Address - Fax:
Practice Address - Street 1:8939 JEFFERSON HWY APT 1503
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2408
Practice Address - Country:US
Practice Address - Phone:225-803-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221967363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily