Provider Demographics
NPI:1811454077
Name:AARON, BENJAMIN THOMAS (FNP-C)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:THOMAS
Last Name:AARON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 IRIS LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-7528
Mailing Address - Country:US
Mailing Address - Phone:931-456-2728
Mailing Address - Fax:931-400-5155
Practice Address - Street 1:768 S WILLOW AVE STE A
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3892
Practice Address - Country:US
Practice Address - Phone:931-559-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily