Individual
STEPHANIE BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 KANAKANAK RD., DILLINGHAM, AK 99576-0130
(907) 842-5201
(907) 842-9250
Mailing address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-5201
(907) 842-9250
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
14-1314-III
AK
Other
Enumeration date
04/29/2015
Last updated
03/27/2023
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