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Brooke Davis Benincosa
General Practice Registered Nurse in Huntsville, Utah
NPI 1194440180

Brooke Davis Benincosa is a General Practice Registered Nurse based in Huntsville, UT and is specialized in General Practice. Brooke Davis Benincosa practices in Huntsville, UT. The NPI Number for Brooke Davis Benincosa is 1194440180 and holds a License No. 8145482-3102 (Utah).

The current practice location address for Brooke Davis Benincosa is 2891 Evergreen Park Dr, Huntsville, UT and can be reached out via phone at 801-497-1872.

Location: 2891 Evergreen Park Dr, Huntsville, UT, 84317-9686
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194440180
Provider Name
Brooke Davis Benincosa
Credential
Provider Entity Type
Individual
Gender
Female
Address
2891 Evergreen Park Dr, Huntsville, UT, 84317-9686
Phone Number
801-497-1872
Fax Number
Provider Enumeration Date
10/11/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8014971872 05 UT
institution
Provider Business Practice Location Address Details
Address
2891 Evergreen Park Dr
City
Huntsville
State
Utah
Zip
84317-9686
Phone Number
801-497-1872
Fax Number
person
Provider Business Mailing Address Details
Address
2891 Evergreen Park Dr
City
Huntsville
State
Utah
Zip
84317-9686
Phone Number
801-497-1872
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
General Practice
Taxonomy
163WG0000X
License No.
8145482-3102 (Utah)
Definition
Definition to come...
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