Individual
JESSICA BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
239 PLEASANT ST, CONCORD, NH 03301-7504
(603) 224-6561
Mailing address
7 CABERNET DR, #3, CONCORD, NH 03303-1042
(313) 330-0776
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704272358
MI
363LG0600X
Gerontology Nurse Practitioner
4704272358
MI
Other
Enumeration date
03/14/2014
Last updated
07/28/2015
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