Individual
MS. JILLIAN BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 RODEO DR STE A, ERLANGER, KY 41018-1279
(513) 354-3700
Mailing address
6480 HARRISON AVE STE 201, CINCINNATI, OH 45247-7961
(513) 354-7650
(513) 354-7651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005026RX
OH
363A00000X
Physician Assistant
TC982
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99075394A
LICENSE
IN
Enumeration date
09/28/2016
Last updated
11/02/2020
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