Individual
LORI LYNNETTE BENVENUTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1525 BLUE SPRUCE DR, FORT COLLINS, CO 80524-2004
(970) 498-6712
Mailing address
1525 BLUE SPRUCE DR, FORT COLLINS, CO 80524-2004
(970) 498-6712
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
1623592
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1623592
NURSING LICENSE
CO
Enumeration date
06/10/2016
Last updated
06/10/2016
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