Provider Demographics
NPI:1215956248
Name:BENKER, JOYCE (NP)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:BENKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:BENKER-RITCHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4 LAKE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2507
Mailing Address - Country:US
Mailing Address - Phone:508-420-9436
Mailing Address - Fax:
Practice Address - Street 1:1132 WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3878
Practice Address - Country:US
Practice Address - Phone:413-592-1980
Practice Address - Fax:413-439-0096
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA136708363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA83-02253OtherEVERCARE
MA83-02253OtherEVERCARE