Healthcare Provider Details

I. General information

NPI: 1760365209
Provider Name (Legal Business Name): ANNA LYN BENSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 W WASHINGTON ST
BRAINERD MN
56401-2924
US

IV. Provider business mailing address

25632 E CLARK LAKE RD
NISSWA MN
56468-2811
US

V. Phone/Fax

Practice location:
  • Phone: 218-825-0027
  • Fax:
Mailing address:
  • Phone: 701-630-1594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number127008
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: