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General NPI Number Information
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NPI Number | 1023718574
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Entity Type | Individual
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Provider Name | JAMES DAVID BENSON AGNP-C, PHD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 170 ARROWHEAD DR STE 2
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City | EVANSTON
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State | WY
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Zip | 82930-9307
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Country | US
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Telephone | 307-212-6270
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Fax | 307-212-6271
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Provider Business Mailing Address
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Address Line | 170 ARROWHEAD DR STE 2
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City | EVANSTON
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State | WY
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Zip | 82930-9307
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Country | US
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Telephone | 307-212-6270
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Fax | 307-212-6271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 51288
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 51288
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License Number State | WY
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