Individual
NICOLE S BENZONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1800 NW MYHRE RD, SILVERDALE, WA 98383-7663
(360) 744-6525
(360) 744-8530
Mailing address
1800 NW MYHRE RD, SILVERDALE, WA 98383-7663
(360) 744-6525
(360) 744-8530
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2020039005
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2020013242
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2020039005
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD61251859
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2211804
—
WA
Enumeration date
06/15/2017
Last updated
09/21/2022
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