Individual
KIMBERLY KAY BENKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
44201 DEQUINDRE RD STE EC, TROY, MI 48085-1117
(248) 259-3088
(248) 964-6133
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1865
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704386315
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111452
—
OH
Enumeration date
01/09/2014
Last updated
07/27/2022
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