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Individual

AMY ROSE BENENSON

Active
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Individual

AMY ROSE BENENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPAS, PA-C

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
PA01468
RI
363AM0700X
Medical Physician Assistant
Primary
5717
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA01468
RI
Enumeration date
06/15/2022
Last updated
01/04/2024
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