Individual
PAUL D BENINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-2754
(605) 322-2727
Mailing address
PO BOX 5045, C.B.O. PROV ENROLLMT, SIOUX FALLS, SD 57117-5045
(605) 322-2754
(605) 322-2727
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R023547
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006253
SD BLUE CROSS IND #
SD
01
—
0030016
SD BLUE CROSS GROUP#
SD
05
—
006965500
—
MN
01
—
013K7BE
MN BCBS PROV#
MN
05
—
0573493
—
IA
05
—
460224743-48
—
NE
05
—
5750954
—
SD
05
—
5750955
—
SD
Enumeration date
07/07/2006
Last updated
05/09/2014
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