Individual
AMY CORINNE BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 CEDAR ST SE, SUITE 7600, ALBUQUERQUE, NM 87106-4917
(505) 563-2500
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1077166
NCCPA CERT NUMBER
NM
Enumeration date
05/25/2007
Last updated
11/03/2016
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