| Doctor Name: | KIRSTEN ANGELIQUE BENFORD |
| NPI Number: | 1891711552 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.N.P. |
| License Number: | 602448 |
| Business Practice Address: | 149 Hart St 82 Medical Group/credentials Sheppard Afb, TX - 763113477 |
| Business Phone Number: | 9406760132 |
| Business Fax Number: | |
| Mailing Address: | 149 Hart St Rm 5, SHEPPARD AFB |
| State: | TX |
| Postal Code: | 763113483 |
| Phone Number: | 9406760132 |
| Fax Number: | 9406760483 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 10/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 602448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |