Provider Demographics
NPI:1124786538
Name:BENTON, RACHEL LEIGH (PA-C)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LEIGH
Last Name:BENTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7030 S YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2016
Mailing Address - Country:US
Mailing Address - Phone:303-721-9984
Mailing Address - Fax:303-267-7304
Practice Address - Street 1:7030 S YOSEMITE ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2016
Practice Address - Country:US
Practice Address - Phone:303-721-9984
Practice Address - Fax:303-267-7304
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007043363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant