Provider Demographics
NPI:1104814193
Name:BENSON, ERIKA L (CNP)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:BENSON
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5395
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-5395
Mailing Address - Country:US
Mailing Address - Phone:505-982-6247
Mailing Address - Fax:505-982-6280
Practice Address - Street 1:1035 ALTO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2406
Practice Address - Country:US
Practice Address - Phone:505-982-6247
Practice Address - Fax:505-982-6280
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR51371363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM08439711Medicaid
NM08439711Medicaid
NM343512201Medicare ID - Type Unspecified