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Individual
VICKI LOU BENTON
Active
Individual
VICKI LOU BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22598
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137821812
—
TX
01
—
430027383
RAILROAD MEDICARE
TX
01
—
88597C
TX-BLUE SHIELD
—
Enumeration date
01/04/2007
Last updated
03/07/2011
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