Healthcare Provider Details

I. General information

NPI: 1669416525
Provider Name (Legal Business Name): LINDA A BENSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA A MCALPINE

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 JOHN ST BOX 42
KALAMAZOO MI
49007-5341
US

IV. Provider business mailing address

601 JOHN ST BOX M510
KALAMAZOO MI
49007-5341
US

V. Phone/Fax

Practice location:
  • Phone: 269-341-6417
  • Fax: 269-341-8743
Mailing address:
  • Phone: 269-341-7762
  • Fax: 269-341-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number4704218394
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: