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NICOLE S BENAVIDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 935-4000
(254) 935-4111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP115546
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
185590003
TX
01
185590004
CSHCN
TX
Enumeration date
01/30/2007
Last updated
12/13/2021
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