Provider Demographics
NPI:1063745123
Name:GARCIA-BENOIT, CAROL A (RNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:GARCIA-BENOIT
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:727 EAST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6185
Practice Address - Country:US
Practice Address - Phone:401-725-6160
Practice Address - Fax:401-722-5430
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37516363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICG77589Medicaid