Individual
JENNIFER BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8500 EDINBROOK PKWY, BROOKLYN PARK, MN 55443
(763) 425-1211
Mailing address
8500 EDINBROOK PKWY, BROOKLYN PARK, MN 55443-3720
(763) 425-1211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R 165945-0
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
20111983
MN
Other
Enumeration date
06/18/2007
Last updated
09/12/2024
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