Provider Demographics
NPI:1407742521
Name:BENSON, NATALIE BROOKE (NP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:BROOKE
Last Name:BENSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:LEAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1425 WEBBS MILL RD N
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-3591
Mailing Address - Country:US
Mailing Address - Phone:540-271-8386
Mailing Address - Fax:
Practice Address - Street 1:314 FAIRY STREET EXT STE A
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1913
Practice Address - Country:US
Practice Address - Phone:276-638-5437
Practice Address - Fax:276-666-6686
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193765363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty