Provider Demographics
NPI:1134768625
Name:BLANCO BENAVIDES, NIURKA (FNP)
Entity type:Individual
Prefix:
First Name:NIURKA
Middle Name:
Last Name:BLANCO BENAVIDES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18532 KUYKENDAHL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8160
Mailing Address - Country:US
Mailing Address - Phone:713-804-5961
Mailing Address - Fax:
Practice Address - Street 1:18532 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8160
Practice Address - Country:US
Practice Address - Phone:713-804-5961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX981143163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse