Provider Demographics
NPI:1639177421
Name:BENKO, SANDRA S (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:S
Last Name:BENKO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3922
Mailing Address - Country:US
Mailing Address - Phone:717-846-8869
Mailing Address - Fax:
Practice Address - Street 1:1207 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3922
Practice Address - Country:US
Practice Address - Phone:717-846-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP-005931-B363L00000X
PARN-186720-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS85672Medicare UPIN