Provider Demographics
NPI:1164829388
Name:BENZ, DEANNA (PHARMD)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:BENZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:NOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6387 RAMSEY ST UNIT 130
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9442
Mailing Address - Country:US
Mailing Address - Phone:910-615-3900
Mailing Address - Fax:910-321-6220
Practice Address - Street 1:6387 RAMSEY ST UNIT 130
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9442
Practice Address - Country:US
Practice Address - Phone:910-615-3900
Practice Address - Fax:910-321-6220
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist