Healthcare Provider Details

I. General information

NPI: 1609761469
Provider Name (Legal Business Name): BRIANNA ALLYN BENSON BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 CHALKSTONE AVE
PROVIDENCE RI
02908-4728
US

IV. Provider business mailing address

60 STRAWBERRY ST
LISBON CT
06351-2836
US

V. Phone/Fax

Practice location:
  • Phone: 401-456-4000
  • Fax:
Mailing address:
  • Phone: 860-917-7405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number201826
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN78807
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: