MEDICARE: KAY BENSCHOP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	R 125764-5	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	181585	OTHER	MN	UCARE MN PCA
2	106502	OTHER	MN	UCARE MN
3	37865	OTHER	MN	HEALTHPARTNERS
4	4J19CA	OTHER	MN	BCBS
5	5900010	OTHER	MN	MEDICA

General Provider Information

NPI Number	:	1154452613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY BENSCHOP

Provider Business Mailing Address
First Line	:	2339 TART LAKE RD
Second Line	:
City	:	LINO LAKES
State	:	MN
Zip	:	55038-7730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1953 UNIVERSITY AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-3427
Country	:	US
Telephone Number	:	651-659-0208
Fax Number	:	651-659-0161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/09/2007

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Directions to “ KAY BENSCHOP ” Practice Location

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