Individual
JESSICA DAWN BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
282 ALTA VIEW DR SW, WILLIS, VA 24380-4915
(540) 488-4349
Mailing address
282 ALTA VIEW DR SW, WILLIS, VA 24380-4915
(540) 488-4349
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0102206119
VA
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
0102206119
VA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
0102206119
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447230495
—
NC
Enumeration date
01/18/2006
Last updated
05/12/2020
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