Provider Demographics
NPI:1023718574
Name:BENSON, JAMES DAVID (AGNP-C, PHD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DAVID
Last Name:BENSON
Suffix:
Gender:M
Credentials:AGNP-C, PHD
Other - Prefix:
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Mailing Address - Street 1:170 ARROWHEAD DR STE 2
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-9307
Mailing Address - Country:US
Mailing Address - Phone:307-212-6270
Mailing Address - Fax:307-212-6271
Practice Address - Street 1:170 ARROWHEAD DR STE 2
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-9307
Practice Address - Country:US
Practice Address - Phone:307-212-6270
Practice Address - Fax:307-212-6271
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY51288363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology