Provider Demographics
NPI:1841601176
Name:BENTER, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W 5TH ST.
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:SD
Mailing Address - Zip Code:57523-0147
Mailing Address - Country:US
Mailing Address - Phone:605-775-2228
Mailing Address - Fax:
Practice Address - Street 1:145 W 5 ST
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:SD
Practice Address - Zip Code:57523-0147
Practice Address - Country:US
Practice Address - Phone:605-775-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD-RNR025938163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health