Benincosa, Brooke Davis

Benincosa, Brooke Davis is an sole proprietor health care provider with primary practice located at 2891 Evergreen Park Dr , Huntsville UT 84317-9686. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Benincosa, Brooke Davis can be contacted via phone (801) 497-1872.

Contact Information

Primary practice address
2891 Evergreen Park Dr Huntsville UT 84317-9686
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 8145482-3102 Utah

Profile Details

NPI number 1194440180
LBN Legal business name Benincosa, Brooke Davis
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2022
Last updated Oct 11th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1194440180 NPPES
Utah MEDICAID 8014971872

Popular Providers