Provider Demographics
NPI:1487100640
Name:BENNION-SMITH, LINDA KAREN
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAREN
Last Name:BENNION-SMITH
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 1:3400 55TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0123
Mailing Address - Country:US
Mailing Address - Phone:507-280-7665
Mailing Address - Fax:507-280-7725
Practice Address - Street 1:3400 55TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0123
Practice Address - Country:US
Practice Address - Phone:507-280-7665
Practice Address - Fax:507-280-7725
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist