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Individual
MRS. CAEDORA MARYLOUISE BENTON
Active
Individual
MRS. CAEDORA MARYLOUISE BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP, PMHNP, FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
264004
NC
363LF0000X
Family Nurse Practitioner
0024183725
VA
363LF0000X
Family Nurse Practitioner
5012193
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5012193
NC
Other
Enumeration date
09/04/2019
Last updated
04/08/2025
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