MEDICARE: MS. TIMETRICE ANISHA BENSON FNP-BC

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	363LF0000X	Family Nurse Practitioner	4704287834	MI

General Provider Information

NPI Number	:	1780329813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIMETRICE ANISHA BENSON FNP-BC

Provider Business Mailing Address
First Line	:	5103 W PIERSON RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48504-1301
Country	:	US
Telephone Number	:	810-212-0605
Fax Number	:	810-488-7464

Provider Business Practice Location Address
First Line	:	5103 W PIERSON RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48504-1301
Country	:	US
Telephone Number	:	810-212-0605
Fax Number	:	810-488-7464

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

Provider Enumeration Date	:	05/03/2022
Last Update Date	:	04/15/2026

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