Provider Demographics
NPI:1922787563
Name:BENSON, CARMEN (FNP-C, RN)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:FNP-C, RN
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:VIGIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1436 WIND RIDGE DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3893
Mailing Address - Country:US
Mailing Address - Phone:505-720-7247
Mailing Address - Fax:
Practice Address - Street 1:609 S CHRISTOPHER RD
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002
Practice Address - Country:US
Practice Address - Phone:505-864-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM74603363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily