Provider Demographics
NPI:1366259111
Name:BENAMARA, JUSTINA LEE (PMHNP, MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:JUSTINA
Middle Name:LEE
Last Name:BENAMARA
Suffix:
Gender:F
Credentials:PMHNP, MSN, RN
Other - Prefix:
Other - First Name:JUSTINA
Other - Middle Name:LEE
Other - Last Name:MERICAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MARRIED NAME- RN
Mailing Address - Street 1:332 CULPEPER ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3003
Mailing Address - Country:US
Mailing Address - Phone:609-937-0523
Mailing Address - Fax:
Practice Address - Street 1:158 FRONT ROYAL PIKE STE 206
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4324
Practice Address - Country:US
Practice Address - Phone:540-304-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024191757363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health