Healthcare Provider Details

I. General information

NPI: 1831093814
Provider Name (Legal Business Name): JAMIE LYN BENZING FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 N STATE ST
SAINT IGNACE MI
49781-1013
US

IV. Provider business mailing address

2565 NICHOLS RD
PELLSTON MI
49769-9365
US

V. Phone/Fax

Practice location:
  • Phone: 906-643-8585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704364135
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: