Provider Demographics
NPI:1689668758
Name:BENSON, DEBRA ANN (NP C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:BENSON
Suffix:
Gender:F
Credentials:NP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WASHINGTON ST
Mailing Address - Street 2:SUITE 2 & 4
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3441
Mailing Address - Country:US
Mailing Address - Phone:781-551-3535
Mailing Address - Fax:781-255-9994
Practice Address - Street 1:886 WASHINGTON ST
Practice Address - Street 2:STE 2
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3445
Practice Address - Country:US
Practice Address - Phone:781-551-3535
Practice Address - Fax:781-255-9994
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAF0802155363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner