Most Relevant Information
Provider Data
| NPI Number: | 1003425380 |
| Provider Name: | KHIRA LAUREN BENSON CNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704406329 |
Most Important Dates
| Enumeration Date: | 07/23/2020 |
| Last Updated: | 04/15/2024 |
Provider Practice Location
25 MICHIGAN ST NE STE 4200
GRAND RAPIDS
MI
495032559
Practice Location Phone/Fax
| Phone: | 6162679150 |
| Fax: |
Provider Mailing Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS
MI
495032560
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |