Individual
MRS. JENNIFER LYNN BENDER-STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
9900 BIRCH RUN RD STE D, BIRCH RUN, MI 48415
(989) 624-1575
(989) 624-1507
Mailing address
PO BOX 779, TAWAS CITY, MI 48764-0779
(989) 624-1575
(989) 624-1507
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704264079
MI
363LF0000X
Family Nurse Practitioner
Primary
4704264079
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381893324
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/02/2012
Last updated
04/06/2021
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