Basic Information
| Provider Information | |||||||||
| NPI: | 1578554341 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENIGNO | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 924 SHEFFIELD FOREST CT | ||||||||
| Address2: | |||||||||
| City: | WILDWOOD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630212054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363461816 | ||||||||
| FaxNumber: | 3147752821 | ||||||||
| Practice Location | |||||||||
| Address1: | 14825 N OUTER 40 | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630172152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6368984707 | ||||||||
| FaxNumber: | 6368984709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 143741 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.