Individual
OLGA NELLY BENITEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 983-8601
Mailing address
6195 LONGHORN TRL, STEVENSVILLE, MI 49127-8462
(773) 983-6333
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
4704315625
MI
363L00000X
Nurse Practitioner
Primary
4704315625
MI
363LF0000X
Family Nurse Practitioner
4704315625
MI
Other
Enumeration date
01/21/2025
Last updated
04/08/2025
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