Provider Demographics
NPI:1982995585
Name:BENIGNO, MA AIMEE BARADERO (MSN, NNP-BC, RNC-NIC)
Entity Type:Individual
Prefix:MRS
First Name:MA AIMEE
Middle Name:BARADERO
Last Name:BENIGNO
Suffix:
Gender:F
Credentials:MSN, NNP-BC, RNC-NIC
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Mailing Address - Street 1:3351 E JOSEPH WAY
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2106
Mailing Address - Country:US
Mailing Address - Phone:480-656-6021
Mailing Address - Fax:
Practice Address - Street 1:300 W CLARENDON AVE STE 375
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3476
Practice Address - Country:US
Practice Address - Phone:602-277-4161
Practice Address - Fax:602-266-3481
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP20670363LN0005X
AZ122866363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care