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Individual

ALYSSA BENNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0001
(434) 924-2101
(434) 982-2580
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005572
VA
363AS0400X
Surgical Physician Assistant
0110005572
VA
363AS0400X
Surgical Physician Assistant
PA030335
DC

Other

Enumeration date
02/14/2007
Last updated
12/03/2021
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