Healthcare Provider Details

I. General information

NPI: 1386501849
Provider Name (Legal Business Name): HEATHER BENCHLEY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 N CLARE AVE
HARRISON MI
48625-8250
US

IV. Provider business mailing address

8375 S CORNWELL AVE
CLARE MI
48617-8513
US

V. Phone/Fax

Practice location:
  • Phone: 989-539-2141
  • Fax:
Mailing address:
  • Phone: 989-588-1972
  • Fax: 989-588-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number4704337946
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: