Anne M Benson, FNPC

Individual provider Active NPI Nurse Practitioner · Prescott, AZ

NPI 1487780482 · NPPES record last updated Apr 16, 2013

Key facts

NPI
1487780482
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
RN043683 (AZ)
Practice address
3112 Clearwater Dr Ste a
Prescott, AZ 86305-7187
Phone
(928) 776-4612
Fax
(928) 771-1767
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
800AZMDOrthopedic Physical Therapist
RN043683AZMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN043683 AZ Yes

Addresses

Primary practice location

3112 Clearwater Dr Ste a
Prescott, AZ 86305-7187

Mailing address

3112 Clearwater Dr Ste a
Prescott, AZ 86305-7187
Phone (928) 776-4612

Other identifiers

IdentifierTypeStateIssuer
889678MedicaidAZ

Other providers in Prescott, AZ

All providers in Prescott, AZ · Nurse Practitioner in Arizona

Sources for this page

Verify at the official NPI Registry.