Healthcare Provider Details

I. General information

NPI: 1164684742
Provider Name (Legal Business Name): KAY LYNN BENKO M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HERITAGE WAY STE 201
KALISPELL MT
59901-3127
US

IV. Provider business mailing address

1095 LOS PALOS DR
SALINAS CA
93901-3916
US

V. Phone/Fax

Practice location:
  • Phone: 406-752-1014
  • Fax: 406-756-1379
Mailing address:
  • Phone: 831-422-8798
  • Fax: 831-422-0153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number7369
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number7369
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number7369
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: