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Individual

WYNELLE P BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1423 PALMETTO RD, VERONA, MS 38879
(662) 566-5593
(662) 566-4419
Mailing address
PO BOX 429, VERONA, MS 38879-0429
(662) 566-5593
(662) 566-4419

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R558168
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0111505
MS
Enumeration date
08/15/2006
Last updated
07/08/2007
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