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Individual
BROOKE SPROUSE BENTON
Active
Individual
BROOKE SPROUSE BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD LPN CDE
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L002187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00156469
RAILROAD
NC
Enumeration date
09/20/2006
Last updated
12/17/2007
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