Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0090-00767 | NC |
Y | 111NI0900X | Internist | 0090-00767 | NC |
N | 207RH0002X | Hospice and Palliative Medicine | 0101262400 | VA |
N | 207RH0002X | Hospice and Palliative Medicine | 078751 | GA |
N | 207RH0002X | Hospice and Palliative Medicine | 56214 | TN |
NPI | 1295759538 |
---|---|
Provider Name | Dr. Alisha Beth Benner |
First Address | Nashville, TN 37201-1835 |
Second Address | Winston Salem, NC 27103-1368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I37003 | (02) |