Provider Demographics
NPI:1134455363
Name:BENEDICT, PATRICIA LOUISE (MSN,FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOUISE
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:540 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WINAMAC
Mailing Address - State:IN
Mailing Address - Zip Code:46996-1173
Mailing Address - Country:US
Mailing Address - Phone:574-946-2194
Mailing Address - Fax:574-946-7801
Practice Address - Street 1:716 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-3083
Practice Address - Country:US
Practice Address - Phone:219-866-0485
Practice Address - Fax:219-866-0837
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71003093A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71003093AOtherANP