Individual
JENNIFER ANNE BENEDICT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
401 E LANTRIP ST, KILGORE, TX 75662-5956
(903) 983-0081
(903) 983-0082
Mailing address
401 E LANTRIP ST, KILGORE, TX 75662-5956
(903) 983-0081
(903) 983-0082
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP113709
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824N42
BCBS
TX
01
—
TIN PLUS 022
TRICARE
TX
Enumeration date
05/16/2006
Last updated
02/05/2023
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