Fernando Benitez
Individual provider Active NPI Community Health Worker · White Bear Lake, MN
NPI 1740934405 · NPPES record last updated Feb 10, 2022
Key facts
- NPI
- 1740934405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 2121 1St St
White Bear Lake, MN 55110-3413 - Phone
- (651) 338-8247
- NPI assigned
- Feb 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | MN | Yes |
Addresses
Primary practice location
2121 1St St
White Bear Lake, MN 55110-3413
Mailing address
2121 1St St
White Bear Lake, MN 55110-3413
Phone (651) 338-8247
Other providers in White Bear Lake, MN
- Bradley Thomas Beauchene
- Melissa Rose Beaudry
- Jane E Beer
- Diane Annette Beers
- Beneficial Alcove Massage and Wellness Clinic
- Cascia Berman
- Monica Beulke
- Mulatu Geleto Bino
- Birch Behavioral Medicine, PLLC
- Birch Lake Chiropractic Clinic, LLC
All providers in White Bear Lake, MN · Community Health Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.