Provider Demographics
NPI:1124291133
Name:BENSON, REBECCA (DNP,MSN,CS-P)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:DNP,MSN,CS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 KIRKWOOD HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4857
Mailing Address - Country:US
Mailing Address - Phone:302-224-1711
Mailing Address - Fax:302-513-9967
Practice Address - Street 1:5700 KIRKWOOD HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4857
Practice Address - Country:US
Practice Address - Phone:302-224-1711
Practice Address - Fax:302-513-9967
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELE-0000103364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1124291133Medicaid