Provider Demographics
NPI:1184854291
Name:LINTHICUM, BENJAMIN O (NP)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:O
Last Name:LINTHICUM
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 MARKET CENTER DR # 130
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7504
Mailing Address - Country:US
Mailing Address - Phone:984-960-1200
Mailing Address - Fax:
Practice Address - Street 1:1901 HILLANDALE RD
Practice Address - Street 2:SUITE D
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2664
Practice Address - Country:US
Practice Address - Phone:919-383-4355
Practice Address - Fax:919-382-8791
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC207061 (RN)363LF0000X
NC5004396363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily