Individual provider Active NPI

Gladys Susan Benavente, MSN, ANP-C, CNN

  • Primary Care Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1083659213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN036680 Issued in AZ
Practice address
3601 S.6TH Ave
MC -5-121a
Tucson, AZ 85723-0001
Phone
(520) 792-1450
Fax
(520) 629-1764
NPI assigned
Jun 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN036680 AZ Primary

Addresses

Primary practice location

3601 S.6TH Ave
MC -5-121a
Tucson, AZ 85723-0001

Mailing address

6141 N Ginger Ave
Tucson, AZ 85741-3672
Phone (520) 544-0132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN036680AZMDPrimary Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083659213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 N GINGER AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413672",
            "telephone_number": "520-544-0132",
            "fax_number": "520-742-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S.6TH AVE",
            "address_2": "MC -5-121A",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857230001",
            "telephone_number": "520-792-1450",
            "fax_number": "520-629-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVENTE",
        "first_name": "GLADYS",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "MSN, ANP-C, CNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "RN036680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.