Provider Demographics
NPI:1831631464
Name:BENTON, CHRISTEN MICHELLE (CSFA, CST, BA)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:MICHELLE
Last Name:BENTON
Suffix:
Gender:F
Credentials:CSFA, CST, BA
Other - Prefix:
Other - First Name:CHRISSY
Other - Middle Name:
Other - Last Name:BENTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSFA
Mailing Address - Street 1:2537 CEDARCREST RD STE 305-14
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8900
Mailing Address - Country:US
Mailing Address - Phone:678-758-8164
Mailing Address - Fax:770-336-6620
Practice Address - Street 1:2537 CEDARCREST RD STE 305-14
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8900
Practice Address - Country:US
Practice Address - Phone:678-758-8164
Practice Address - Fax:770-336-6620
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical