Healthcare Provider Details

I. General information

NPI: 1649174913
Provider Name (Legal Business Name): LENORE LOUISE BENTON-BEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 53RD AVE
BETTENDORF IA
52722-7564
US

IV. Provider business mailing address

1610 E 33RD ST
DAVENPORT IA
52807-2012
US

V. Phone/Fax

Practice location:
  • Phone: 563-421-9300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA194565
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: