Provider Demographics
NPI:1750376752
Name:BENJAMIN, DARLENE (CRNP)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MORGAN HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2641
Mailing Address - Country:US
Mailing Address - Phone:570-344-3788
Mailing Address - Fax:570-969-9280
Practice Address - Street 1:5 MORGAN HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2641
Practice Address - Country:US
Practice Address - Phone:570-344-3788
Practice Address - Fax:570-969-9280
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP-007014-B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA500022179OtherRAILROAD MEDICARE
PA50076560OtherCAPITAL BLUE CROSS
PA050184OtherBLUE CARE
PA500022179OtherRAILROAD MEDICARE
PAP37842Medicare UPIN