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Individual
PRISCILLA JEAN BENNER
Active
Individual
PRISCILLA JEAN BENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD017870E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006280500004
—
PA
01
—
0045794001
KEYSTONE EAST
PA
01
—
090232
AMERIHEALTH
PA
01
—
1026082
KEYSTONE MERCY
PA
01
—
50002697
CAPITAL BLUE CROSS
PA
01
—
610383300
BLACK LUNG
PA
01
—
P3152581
OXFORD
PA
Enumeration date
07/28/2005
Last updated
06/08/2015
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