Individual
JESSICA ANNMARIE BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10415 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 390-0451
Mailing address
10415 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 390-0451
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
93042
NC
Other
Enumeration date
07/27/2013
Last updated
03/27/2023
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