Provider Demographics
NPI:1891001780
Name:BENFORD, VERONICA DENISE
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:DENISE
Last Name:BENFORD
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 1:3701 DORADO CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-2814
Mailing Address - Country:US
Mailing Address - Phone:901-937-8242
Mailing Address - Fax:
Practice Address - Street 1:3701 DORADO CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-2814
Practice Address - Country:US
Practice Address - Phone:901-937-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide