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CORY MARIE BENTON — OIG Excluded Provider (MESA, AZ, 1128b4)

CORY MARIE BENTON — OIG Excluded Provider (MESA, AZ, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: CORY MARIE BENTON; Type: Individual; Provider category: IND- LIC HC SERV PRO.

NameCORY MARIE BENTON
TypeIndividual
Provider categoryIND- LIC HC SERV PRO
SpecialtyNURSE/NURSES AIDE
NPI1154625937
CityMESA
StateAZ
ZIP85206
Exclusion authority1128b4
Exclusion reasonLicense revocation, suspension, or surrender
Exclusion date2015-09-20
SourceHHS-OIG LEIE

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