Provider Demographics
NPI:1043070238
Name:BENSON, JONATHAN (APRN, CNS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:BENSON
Suffix:
Gender:M
Credentials:APRN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E MEADOWSIDE PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3705
Mailing Address - Country:US
Mailing Address - Phone:605-268-0546
Mailing Address - Fax:
Practice Address - Street 1:2001 S SUMMIT AVE NURSING DEPARTMENT
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57197-0001
Practice Address - Country:US
Practice Address - Phone:605-274-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCS004137364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health