Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 402219 | NY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN.0993859-NP | CO |
NPI | 1003338583 |
---|---|
Provider Name | Mr. Robert Hofmann Benge |
First Address | Englewood, CO 80112-5095 |
Second Address | Littleton, CO 80120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2017 |
Last Update Date | 01/08/2018 |