| Doctor Name: | MRS. JESSICA MICHELLE BENTON |
| NPI Number: | 1194140707 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | RN2269840 |
| Business Practice Address: | 52 Crest Ave Suite 1 Winthrop, MA - 021521064 |
| Business Phone Number: | 6178468622 |
| Business Fax Number: | 6178468498 |
| Mailing Address: | 52 Crest Ave, Suite 1 WINTHROP |
| State: | MA |
| Postal Code: | 021521064 |
| Phone Number: | 6178468622 |
| Fax Number: | 6178468498 |
| NPI Enumeration Date: | 02/19/2014 |
| NPI Last Update Date: | 03/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN2269840 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |