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Organization
MAEB PLLC
Active
Organization
MAEB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAEDORA MARYLOUISE BENTON NP (OWNER/CEO)
(678) 499-7794
Entity
Organization
Contact information
Practice address
154 HUFFMAN MILL RD STE 203, BURLINGTON, NC 27215-5113
(336) 298-8088
(464) 777-8135
Mailing address
PO BOX 3, MC LEANSVILLE, NC 27301-0003
(336) 298-8088
(464) 777-8135
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/21/2025
Last updated
09/23/2025
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