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General NPI Number Information
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NPI Number | 1972583649
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Entity Type | Individual
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Provider Name | ASHLI J BENJAMIN PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1640 E TALL TREE RD
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City | DERBY
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State | KS
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Zip | 67037-2000
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Country | US
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Telephone | 316-274-8222
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Fax | 316-651-2344
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Provider Business Mailing Address
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Address Line | PO BOX 8035
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City | WICHITA
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State | KS
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Zip | 67208-0035
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Country | US
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Telephone | 316-689-9135
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Fax | 316-689-9667
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 15-01056
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License Number State | KS
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