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Individual
BRADLEY BENICK
Active
Individual
BRADLEY BENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28219614A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28219614A
INDIANA BOARD OF NURSING
IN
Enumeration date
06/10/2020
Last updated
06/10/2020
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