KEITH DIBENEDETTO (NPI# 1699259580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699259580 |
Entity Type | Individual |
Full Name | KEITH DIBENEDETTO |
Credential | CRNP |
Practice Address |
2617 Stockton Rd Phoenix MD 21131-1117 |
Practice Telephone | 5616329839 |
Mailing Telephone | 5616329839 |
Enumeration Date | 2018-09-18 |
Last Update Date | 2018-09-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
R210044 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
R210044 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2617 STOCKTON RD |
City | PHOENIX |
State | MD |
Zip Code | 21131-1117 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114118387 | Mina Kirkova | Social Worker | 3009 Jackson Ridge Ct, Phoenix, MD 21131 | 2007-08-05 |
1629101381 | Kenneth Barry Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-13 |
1508999798 | Nancy Lee Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-14 |
1093977134 | Amy Ruth Rakusin | Counselor | 10 Cross Creek Ct, Phoenix, MD 21131-1000 | 2008-06-30 |
1932493616 | Kenneth Sharoff, Phd Inc. | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131-1000 | 2011-05-31 |
1063608735 | Catherine Anderson North | Radiology | 1410 Phoenix Rd W, Phoenix, MD 21131-1024 | 2007-09-17 |
1528482643 | Charles Warnke | Speech-Language Pathologist | 13 Stonewood Ct, Phoenix, MD 21131-1116 | 2014-02-10 |
1952775694 | Aileen Mccausland | Occupational Therapy Assistant | 2515 Stockton Rd, Phoenix, MD 21131-1127 | 2015-11-18 |
1124309430 | Amanda Brady Watters Gorman | Registered Nurse | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2011-08-31 |
1366952657 | Ann Bennett | Lactation Consultant, Non-RN | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2017-10-02 |
Find all providers in zip 21131 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831713148 | Alexis Petra Md | Nurse Practitioner | 21835 N 51st St, Phoenix, AZ 85054-7140 | 2020-06-02 |
1326675166 | Kendrick Wright | Nurse Practitioner | 2727 E Camelback Rd Apt 525, Phoenix, AZ 85016-4481 | 2020-03-23 |
1518591510 | Laura Larson | Nurse Practitioner | 1929 W Fillmore St Bldg C, Phoenix, AZ 85009-3812 | 2020-02-27 |
1538709415 | Bertha Nambuye Mbatau | Nurse Practitioner | 2332 W Calle Marita, Phoenix, AZ 85085-7064 | 2020-01-08 |
1790346443 | Elena Nickolaevna Klimova | Nurse Practitioner | 2218 E Wahalla Ln, Phoenix, AZ 85024-1231 | 2019-06-24 |
1306341748 | Kerry L Oliver | Nurse Practitioner | 12010 S Warner Elliot Loop Ste 1, Phoenix, AZ 85044-2731 | 2018-03-28 |
1891294583 | Helena Taboy | Nurse Practitioner | 34975 N North Valley Pkwy Ste 138, Phoenix, AZ 85086-4030 | 2018-02-07 |
1528431152 | Judith Harmon | Nurse Practitioner | 12413 N 41st Pl, Phoenix, AZ 85032-7439 | 2015-11-04 |
1669865408 | Sj Medical Group | Nurse Practitioner | 4622 N 35th Ave, Phoenix, AZ 85017-3403 | 2015-03-17 |
1386032753 | Abcore Medical Group | Nurse Practitioner | 2023 W Bethany Home Rd, Phoenix, AZ 85015-2444 | 2015-01-07 |
Find all providers in PHOENIX |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.