Provider Demographics
NPI:1194722272
Name:BENTON, NANCY (CRNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BENTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4267
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-8267
Mailing Address - Country:US
Mailing Address - Phone:304-723-6040
Mailing Address - Fax:304-723-6039
Practice Address - Street 1:4000 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2364
Practice Address - Country:US
Practice Address - Phone:740-264-8067
Practice Address - Fax:740-346-0413
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV30941363LA2200X
OHAPRN.CNP.03535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP38441Medicare UPIN
WVBENP23181Medicare ID - Type Unspecified
NP23182Medicare PIN
Q03905Medicare UPIN
OHBENP14498Medicare ID - Type Unspecified
OHH273441Medicare PIN