Individual
TARA LEIGH BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1860 SHAWANO AVE, GREEN BAY, WI 54303-2667
(920) 429-1700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15391-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100304120
—
WI
Enumeration date
05/28/2024
Last updated
05/06/2026
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