Provider Demographics
NPI:1386985257
Name:JOSEPH, BENCY (FNP BC)
Entity type:Individual
Prefix:
First Name:BENCY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 SARGENT DALY DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2878
Mailing Address - Country:US
Mailing Address - Phone:423-596-2018
Mailing Address - Fax:
Practice Address - Street 1:2358 LIFESTYLE WAY STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4907
Practice Address - Country:US
Practice Address - Phone:423-475-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17084363LF0000X
TNAPN0000017084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty