Provider Demographics
NPI:1194603936
Name:BENSENHAVER, AMY BRETT (FNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:BRETT
Last Name:BENSENHAVER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 LUNICE CREEK HWY
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847-9301
Mailing Address - Country:US
Mailing Address - Phone:443-474-8447
Mailing Address - Fax:
Practice Address - Street 1:117 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-9566
Practice Address - Country:US
Practice Address - Phone:304-257-1026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV123977261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care