| Doctor Name: | LAUREN BENOLKIN |
| NPI Number: | 1033516570 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.N.P. |
| License Number: | 2014020750 |
| Business Practice Address: | 1601 Saint Francis Ave Ste 100 Shakopee, MN - 553793384 |
| Business Phone Number: | 9524283535 |
| Business Fax Number: | |
| Mailing Address: | 1601 Saint Francis Ave Ste 100, SHAKOPEE |
| State: | MN |
| Postal Code: | 553793384 |
| Phone Number: | 9524283535 |
| Fax Number: | |
| NPI Enumeration Date: | 11/27/2014 |
| NPI Last Update Date: | 11/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 2014020750 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |