Provider Demographics
NPI:1548647670
Name:GYNDER D. BENSON, FNP-BC, PLLC
Entity type:Organization
Organization Name:GYNDER D. BENSON, FNP-BC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GYNDER
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:870-557-7824
Mailing Address - Street 1:201 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-4306
Mailing Address - Country:US
Mailing Address - Phone:870-557-7824
Mailing Address - Fax:
Practice Address - Street 1:201 N 11TH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-4306
Practice Address - Country:US
Practice Address - Phone:870-557-7824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA001641251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care