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General NPI Number Information
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NPI Number | 1316170509
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Entity Type | Individual
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Provider Name | JASON P BENTON CRNP
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Gender | Male
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 109 ADAMS LN
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City | PORTERSVILLE
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State | PA
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Zip | 16051-2419
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Country | US
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Telephone | 724-201-4808
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Fax | 724-220-4505
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Provider Business Mailing Address
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Address Line | 109 ADAMS LN
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City | PORTERSVILLE
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State | PA
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Zip | 16051-2419
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Country | US
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Telephone | 724-201-4808
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Fax | 724-220-4505
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP010989
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN618876
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License Number State | PA
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