Provider Demographics
NPI:1265213417
Name:BENOSCHEK, ROZANNE (LPN)
Entity type:Individual
Prefix:
First Name:ROZANNE
Middle Name:
Last Name:BENOSCHEK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 W ADMIRALTY HEIGHTS LN APT E104
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-5378
Mailing Address - Country:US
Mailing Address - Phone:360-402-1274
Mailing Address - Fax:
Practice Address - Street 1:26812 40TH AVE S BLDG B
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7229
Practice Address - Country:US
Practice Address - Phone:253-945-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPN61044409164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse