Provider Demographics
NPI:1760365209
Name:BENSON, ANNA LYN (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LYN
Last Name:BENSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25632 E CLARK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:NISSWA
Mailing Address - State:MN
Mailing Address - Zip Code:56468-2811
Mailing Address - Country:US
Mailing Address - Phone:701-630-1594
Mailing Address - Fax:
Practice Address - Street 1:340 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2924
Practice Address - Country:US
Practice Address - Phone:218-825-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN127008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist