Provider Demographics
NPI:1962565549
Name:BENSON, BARBARA JEAN (FNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:BENSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 W WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1370
Mailing Address - Country:US
Mailing Address - Phone:602-843-8078
Mailing Address - Fax:623-247-1939
Practice Address - Street 1:8260 W INDIAN SCHOOL RD
Practice Address - Street 2:#4
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-2980
Practice Address - Country:US
Practice Address - Phone:623-247-2300
Practice Address - Fax:623-247-1939
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZNP160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS52609Medicare UPIN
AZ22292Medicare ID - Type Unspecified