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General NPI Number Information
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NPI Number | 1548647670
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Entity Type | Organization
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Legal Business Name | GYNDER D. BENSON, FNP-BC, PLLC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 201 N 11TH ST
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City | NASHVILLE
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State | AR
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Zip | 71852-4306
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Country | US
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Telephone | 870-557-7824
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N 11TH ST
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City | NASHVILLE
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State | AR
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Zip | 71852-4306
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Country | US
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Telephone | 870-557-7824
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GYNDER DIANE BENSON
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Credential | FNP
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Telephone | 870-557-7824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | A001641
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License Number State | AR
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