Individual
MS. THERESA LYNN BENACQUISTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN BSN OCN
Contact information
Practice address
4646 JOHN R, DETROIT, MI 48201
(313) 576-1000
Mailing address
12335 KENT CT, SOUTHGATE, MI 48195-2315
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
Primary
4704153521
MI
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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