Individual
DAVID CRISTOPHER BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 BALSAM AVE, BOULDER, CO 80304-3404
(303) 440-2001
Mailing address
PO BOX 173894, DENVER, CO 80217-3894
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2965
CO
364SE0003X
Emergency Clinical Nurse Specialist
PA17737
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36352861
—
CO
05
—
OPA177370
—
CA
Enumeration date
11/03/2005
Last updated
05/09/2013
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