| NPI | 1659674463 |
|---|---|
| Former Name | JESSICA L BENTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: MO 2005021013) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2015-04-06 |