Provider Demographics
NPI:1770080442
Name:BENZI, CHRISTOPHE
Entity type:Individual
Prefix:
First Name:CHRISTOPHE
Middle Name:
Last Name:BENZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 NICOLE CT
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-3326
Mailing Address - Country:US
Mailing Address - Phone:218-770-8575
Mailing Address - Fax:
Practice Address - Street 1:1403 NICOLE CT
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-3326
Practice Address - Country:US
Practice Address - Phone:218-770-8575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1093179311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home