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General NPI Number Information
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NPI Number | 1043070238
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Entity Type | Individual
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Provider Name | JONATHAN BENSON APRN, CNS
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Gender | Male
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 2001 S SUMMIT AVE NURSING DEPARTMENT
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City | SIOUX FALLS
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State | SD
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Zip | 57197-0001
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Country | US
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Telephone | 605-274-5449
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 E MEADOWSIDE PL
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City | SIOUX FALLS
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State | SD
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Zip | 57108-3705
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Country | US
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Telephone | 605-268-0546
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Fax |
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | CS004137
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License Number State | SD
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