Provider Demographics
NPI:1881888931
Name:BENSON, JENNIFER ANNE (PA C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:BENSON
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Gender:F
Credentials:PA C
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Mailing Address - Street 1:2513 SHALLOWFORD RD
Mailing Address - Street 2:BLDG 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6809
Mailing Address - Country:US
Mailing Address - Phone:770-516-3500
Mailing Address - Fax:770-516-3500
Practice Address - Street 1:3805 CHEROKEE ST NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2085
Practice Address - Country:US
Practice Address - Phone:770-426-5666
Practice Address - Fax:770-426-9212
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2019-11-06
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Provider Licenses
StateLicense IDTaxonomies
GA003147363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical