Provider Demographics
NPI:1811519671
Name:BENSON, PHILLINE
Entity type:Individual
Prefix:
First Name:PHILLINE
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7068 CHESTNUT HILL ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5106
Mailing Address - Country:US
Mailing Address - Phone:858-480-9786
Mailing Address - Fax:
Practice Address - Street 1:8200 S QUEBEC ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4411
Practice Address - Country:US
Practice Address - Phone:858-480-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO654588163W00000X
CA41881163WL0100X
CO1660679163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse