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Individual

TANISHA BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5391 WEAVER RD, LAKE CHARLES, LA 70605-5245
(337) 564-9009
(337) 270-5603
Mailing address
5391 WEAVER RD, LAKE CHARLES, LA 70605-5245
(337) 564-9009
(337) 270-5603

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20172411
LA

Other

Enumeration date
01/23/2026
Last updated
01/23/2026
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