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General NPI Number Information
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NPI Number | 1255848941
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Entity Type | Individual
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Provider Name | CORTNE BENTON
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Gender | Female
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 1320 HIGHWAY 231 S STE 1
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City | TROY
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State | AL
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Zip | 36081-3000
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Country | US
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Telephone | 334-670-5022
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Fax |
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Provider Business Mailing Address
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Address Line | 2804 REMINGTON GREEN CIR STE 2
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City | TALLAHASSEE
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State | FL
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Zip | 32308-1550
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Country | US
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Telephone | 850-385-4494
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9325121
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9325121
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9325121
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License Number State | FL
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