Provider Demographics
NPI:1083898662
Name:TUTOR, BENJAMIN R (CFNP)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:R
Last Name:TUTOR
Suffix:
Gender:M
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 COURTHOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9562
Mailing Address - Country:US
Mailing Address - Phone:601-932-1223
Mailing Address - Fax:601-932-1291
Practice Address - Street 1:2610 COURTHOUSE CIR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9562
Practice Address - Country:US
Practice Address - Phone:601-932-1223
Practice Address - Fax:601-932-1291
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS829791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily