Provider Demographics
NPI:1770520348
Name:FRANCISCO, BENJAMIN D (APRN)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:D
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:404 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6626
Practice Address - Country:US
Practice Address - Phone:573-882-6921
Practice Address - Fax:573-884-3991
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN114307363L00000X
MO114307363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO446030OtherHEALTHLINK
KS4287202301OtherKANSAS MEDICAID
MO500015458OtherRR MEDICARE
MO131721OtherBLUE SHIELD/BLUE CHOICE
MO425188109Medicaid
MO014080010Medicare PIN
KS4287202301OtherKANSAS MEDICAID
MO500015458OtherRR MEDICARE