Benton, Jean Lazenby

Benton, Jean Lazenby is an individual health care provider with primary practice located at 111 E Third Ave , Gastonia NC 28052-4343. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Benton, Jean Lazenby can be contacted via phone (704) 874-3300.

Contact Information

Primary practice address
111 E Third Ave Gastonia NC 28052-4343
Phone: (704) 874-3300
Fax: (704) 874-0065
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 200956 North Carolina

Profile Details

NPI number 1467458588
LBN Legal business name Benton, Jean Lazenby
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Oct 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467458588 NPPES
North Carolina MEDICAID 7000985

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