=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720515257
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AARON MICHAEL BENSON FNP-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2017
-----------------------------------------------------
Last Update Date | 11/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3601 NE RALPH POWELL RD STE C
-----------------------------------------------------
City | LEES SUMMIT
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64064-2316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-285-5053
-----------------------------------------------------
Fax | 816-842-1974
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5501 NW 62ND TER STE 100
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64151-2412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-842-4440
-----------------------------------------------------
Fax | 816-842-1974
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 53-78013-092
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 2017017454
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------