Provider Demographics
NPI:1457345498
Name:BENNETT, CHRIS ANNE (APRN)
Entity type:Individual
Prefix:MRS
First Name:CHRIS
Middle Name:ANNE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:ANNE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:11260 OLD SEWARD HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3098
Mailing Address - Country:US
Mailing Address - Phone:907-375-9395
Mailing Address - Fax:907-375-9396
Practice Address - Street 1:11260 OLD SEWARD HWY STE 104
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3098
Practice Address - Country:US
Practice Address - Phone:907-375-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily