Provider Demographics
NPI:1962057646
Name:LEVEN, BENJAMIN N
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:N
Last Name:LEVEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 SUMNER HALL DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3129
Mailing Address - Country:US
Mailing Address - Phone:615-460-4500
Mailing Address - Fax:
Practice Address - Street 1:332 SUMNER HALL DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3129
Practice Address - Country:US
Practice Address - Phone:615-460-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26666363LP0808X
TN233089163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse