Provider Demographics
NPI:1083659213
Name:BENAVENTE, GLADYS SUSAN (MSN, ANP-C, CNN)
Entity Type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:SUSAN
Last Name:BENAVENTE
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Gender:F
Credentials:MSN, ANP-C, CNN
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Mailing Address - Street 1:6141 N GINGER AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3672
Mailing Address - Country:US
Mailing Address - Phone:520-544-0132
Mailing Address - Fax:520-742-9117
Practice Address - Street 1:3601 S.6TH AVE
Practice Address - Street 2:MC -5-121A
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:520-629-1764
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZRN036680363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care