Provider Demographics
NPI:1427582782
Name:BENOIT, KRISTE JO
Entity Type:Individual
Prefix:
First Name:KRISTE
Middle Name:JO
Last Name:BENOIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTE
Other - Middle Name:JO
Other - Last Name:BENOIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 922
Mailing Address - Street 2:
Mailing Address - City:CHOUTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74337-0922
Mailing Address - Country:US
Mailing Address - Phone:918-431-2000
Mailing Address - Fax:
Practice Address - Street 1:116 W OLNEY ST
Practice Address - Street 2:
Practice Address - City:CHOUTEAU
Practice Address - State:OK
Practice Address - Zip Code:74337-0922
Practice Address - Country:US
Practice Address - Phone:918-431-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK83407163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health