NPI 1477758696 · live from the CMS NPI Registry
Jennifer Benton
Nurse Practitioner, Pediatrics in Brooklyn Park, MN. National Provider Identifier 1477758696, active.
NPI record
| NPI | 1477758696 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 8500 Edinbrook Pkwy, Brooklyn Park, MN 55443 |
| Practice phone | 763-425-1211 |
| Enumerated | June 18, 2007 |
| Last updated | September 12, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | R 165945-0 (MN) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 20111983 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.