Individual
MS. CANDACE DANIELLE BENFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
3009 N BALLAS RD, DEPT PSYCHIATRY, STE 141A, SAINT LOUIS, MO 63131-2322
(314) 286-1700
(314) 627-7225
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1700
(314) 627-7225
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022034853
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420115486
—
MO
Enumeration date
06/24/2022
Last updated
04/15/2025
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