Provider Demographics
NPI:1053099184
Name:PINAGER, BENITA
Entity type:Individual
Prefix:
First Name:BENITA
Middle Name:
Last Name:PINAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 E BLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-1616
Mailing Address - Country:US
Mailing Address - Phone:614-745-7635
Mailing Address - Fax:
Practice Address - Street 1:1536 E BLAKE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1616
Practice Address - Country:US
Practice Address - Phone:614-745-7635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376798380997251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care