Healthcare Provider Details

I. General information

NPI: 1114039161
Provider Name (Legal Business Name): JANET C BENTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 MEDICAL PKWY STE 630
ANNAPOLIS MD
21401-3059
US

IV. Provider business mailing address

PO BOX 23329
NEW YORK NY
10087-3329
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-2260
  • Fax: 410-224-3090
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR137548
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: