Individual
BENJAMIN R CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5511 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7611
(615) 994-1000
(615) 994-0100
Mailing address
5511 VIRGINIA WAY STE 300, BRENTWOOD, TN 37027-7611
(615) 994-1000
(615) 994-0100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110009244
VA
363A00000X
Physician Assistant
Primary
4462
TN
363AM0700X
Medical Physician Assistant
0110009244
VA
363AM0700X
Medical Physician Assistant
28880
NY
363AM0700X
Medical Physician Assistant
PA16865
TX
Other
Enumeration date
02/05/2021
Last updated
03/24/2026
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