Individual
MS. ETOSHIA RENE BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(800) 458-5653
Mailing address
15 GLENDALE ST, GREENVILLE, SC 29605-3228
(864) 423-8722
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3983
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP1535
MCD#
SC
05
—
NP1535
—
SC
Enumeration date
08/20/2009
Last updated
08/03/2020
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