Beautine Benbow, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP014229 Issued in PA

Practice address

8001 State Rd
Mod II, Suite 106
Philadelphia, PA 19136-2908

Phone

(215) 624-2565

NPI assigned

Sep 28, 2014

Last updated

Oct 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1508269119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SOLLY AVE FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191111923",
            "telephone_number": "512-651-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 STATE RD",
            "address_2": "MOD II, SUITE 106",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191362908",
            "telephone_number": "215-624-2565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 Industrial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "VA",
            "postal_code": "239273140",
            "country_code": "US",
            "telephone_number": "434-572-6916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22280 Jeb Stuart Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "VA",
            "postal_code": "241712999",
            "country_code": "US",
            "telephone_number": "276-694-4361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENBOW",
        "first_name": "BEAUTINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-28",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP014229",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0024177046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oded Ben-Amotz
• Edgar Ben-Josef, MD
• Louise Ben-Naim, PA-C
• Andrea Benack, MD
• Michelle Alexandra Benassai
• Michelle Benbow, CRNP
• Jenny Teresa Bencardino, MD
• Lois A Bencardino, OT
• Casey Benchimol, CRNP
• Benchmark Therapy, Inc

• Psychiatric/Mental Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.