MEDICARE: CATHERINE BENSON CNA

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	376K00000X	Nurse's Aide		MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	348032	OTHER	MN	CLASS A PROFESSIONAL HOME HEALTH AGENCY

General Provider Information

NPI Number	:	1306152269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE BENSON CNA

Provider Business Mailing Address
First Line	:	5775 WAYZATA BLVD
Second Line	:	SUITE 700
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-1222
Country	:	US
Telephone Number	:	612-242-0283
Fax Number	:

Provider Business Practice Location Address
First Line	:	9800 69TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-5664
Country	:	US
Telephone Number	:	612-242-0283
Fax Number	:

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

Provider Enumeration Date	:	08/28/2010
Last Update Date	:	08/28/2010

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Directions to “ CATHERINE BENSON CNA” Practice Location

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