Individual
ROBERT JOHN BENON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, FNP
Contact information
Practice address
2100 YUCCA ST, STUDENT SERVICES BLDG., SANTA FE, NM 87505-5456
(505) 467-2439
(505) 467-2989
Mailing address
1880A CALLE QUEDO, SANTA FE, NM 87505-5433
(505) 438-9139
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R21020
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00069174
—
NM
Enumeration date
07/13/2006
Last updated
07/08/2007
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