Kenneth Preston Benton, RN, CEN
Individual provider Active NPI Emergency Registered Nurse · Gallup, NM
NPI 1851828362 · NPPES record last updated May 15, 2017
Key facts
- NPI
- 1851828362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Registered Nurse 163WE0003X
- License
- 810545 (TX)
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (619) 633-9433
- NPI assigned
- May 15, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 810545 | TX | MD | Emergency Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 810545 | TX | Yes |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Other providers in Gallup, NM
- Aisha Bennett
- Jacqueline Alisia Violet Bennett
- Melissa Bennett
- Joelynn Lotty-Evelyn Benter
- Summer Joy Bentley
- Ronald Wesley Berg
- Jackie L Berkley Jr.
- Maya Rose Bernadett-Peters
- Virginia NMN Bernal
- Troy Anthony Bernardo
All providers in Gallup, NM · Emergency Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.