Individual
MRS. LAURA ANN BENACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
150 ENTRANCE WAY, SAINT PETERS, MO 63376-1645
(636) 916-9920
(636) 916-9176
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(636) 916-9920
(636) 916-9176
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2011036334
MO
Other
Enumeration date
11/05/2011
Last updated
06/24/2015
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