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NPI Code Detail

MEDICARE: KIMBERLY CHRISTINE BENSON PA

MEDICARE: KIMBERLY CHRISTINE BENSON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA.200302LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336474402
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY CHRISTINE BENSON PA
Provider Business Mailing Address
First Line : 180 N 5TH ST
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-2532
Country : US
Telephone Number : 985-370-7546
Fax Number : 985-370-7765
Provider Business Practice Location Address
First Line : 180 N 5TH ST
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-2532
Country : US
Telephone Number : 985-370-7546
Fax Number : 985-370-7765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2009
Last Update Date : 08/28/2013

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Directions to “ KIMBERLY CHRISTINE BENSON PA” Practice Location

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