Provider Demographics
NPI:1881963767
Name:BENSON-MUCHA, CAREN ANN (RN)
Entity type:Individual
Prefix:MS
First Name:CAREN
Middle Name:ANN
Last Name:BENSON-MUCHA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 YEONAS DR SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6555
Mailing Address - Country:US
Mailing Address - Phone:808-673-0893
Mailing Address - Fax:
Practice Address - Street 1:6245 LEESBURG PIKE
Practice Address - Street 2:SUITE 460
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2106
Practice Address - Country:US
Practice Address - Phone:703-531-4618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001175496163W00000X
HI64981163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse