Provider Demographics
NPI:1902440381
Name:KING-BENJAMIN, ALINDA PAULINE
Entity Type:Individual
Prefix:
First Name:ALINDA
Middle Name:PAULINE
Last Name:KING-BENJAMIN
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 1:130 MOUNTAIN MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-7233
Mailing Address - Country:US
Mailing Address - Phone:803-764-4828
Mailing Address - Fax:803-764-4828
Practice Address - Street 1:130 MOUNTAIN MAPLE LN
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-7233
Practice Address - Country:US
Practice Address - Phone:803-764-4828
Practice Address - Fax:803-764-4828
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC227265163WD1100X
SC27511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal