KEITH DIBENEDETTO


Address: 2617 Stockton Rd, Phoenix, MD 21131-1117
Phone: 5616329839

KEITH DIBENEDETTO (NPI# 1699259580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 2617 STOCKTON RD
City PHOENIX
State MD
Zip Code 21131-1117

Providers in the same zip code

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 Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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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
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Competitor

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City PHOENIX
Zip Code 21131

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Dataset Information

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.

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