MEDICARE: MS. JULIE B BENAC NP-C

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
1	363LP2300X	Primary Care Nurse Practitioner	3008650	KY
2	363LF0000X	Family Nurse Practitioner	RN154964	GA

General Provider Information

NPI Number	:	1497058721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE B BENAC NP-C

Provider Business Mailing Address
First Line	:	1515 SHAKERTOWN RD
Second Line	:
City	:	DANVILLE
State	:	KY
Zip	:	40422-9261
Country	:	US
Telephone Number	:	706-987-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 WHITTINGTON PKWY
Second Line	:	STE 100
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-4930
Country	:	US
Telephone Number	:	186-646-0356
Fax Number	:	855-632-8329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	03/09/2026

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