Provider Demographics
NPI:1396470597
Name:BENHAM, STEPHANIE
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:BENHAM
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 1:437 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:OH
Mailing Address - Zip Code:43977-9734
Mailing Address - Country:US
Mailing Address - Phone:740-391-6491
Mailing Address - Fax:
Practice Address - Street 1:437 HIGH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:OH
Practice Address - Zip Code:43977-9734
Practice Address - Country:US
Practice Address - Phone:740-391-6491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant