Benitho Louissaint, NP
Nurse Practitioner, Psych/Mental Health in Tempe, AZ. Individual provider (NPI-1).
NPI number1053834945
StatusActive
Last updated in NPPESOct 29, 2023
Details
- NPI
- 1053834945
- Entity type
- Individual (NPI-1)
- Name
- Mr. Benitho Louissaint
- Credential
- NP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 23, 2017
- Certification date
- Oct 29, 2023
- Last updated
- Oct 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | AP10399 | AZ | Yes |
| 363LF0000X | Nurse Practitioner, Family | AP10399 | AZ |
Practice location
6197 S Rural RdTempe, AZ 85283-2909
Phone 480-471-8980 · Fax 480-912-1061
Mailing address
6197 S Rural RdTempe, AZ 85283-2909
Phone 480-471-8980 · Fax 480-912-1061
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