Individual
MR. BENJAMIN R KADAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
517 W 100 N STE 110, PROVIDENCE, UT 84332-9826
(435) 755-6075
(833) 448-2959
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
(833) 448-2959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
12853375-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11266
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12853376-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3571695
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
58348
WY
Other
Enumeration date
03/14/2006
Last updated
03/13/2026
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