Individual
ANITRA BULLOCK BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
880 WILLIAM BLVD APT 703, RIDGELAND, MS 39157-1596
(601) 850-6577
Mailing address
880 WILLIAM BLVD. 703, RIDGELAND, MS 39157
(601) 850-6577
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
881988
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
908079
MS
Other
Enumeration date
11/06/2023
Last updated
01/22/2026
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