Provider Demographics
NPI:1821597881
Name:BENNER, JENNIFER TAYLOR (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:TAYLOR
Last Name:BENNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4755 OGLETOWN STANTON RD STE 1E20
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-733-5700
Mailing Address - Fax:302-733-5775
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 1E20
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-733-5700
Practice Address - Fax:302-733-5775
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR151936163W00000X, 363LF0000X
DELG-0001128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse