Healthcare Provider Details

I. General information

NPI: 1841464625
Provider Name (Legal Business Name): CHRIS FEIGHTNER BLANNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 JENNYCLIFFE LN
CHESTERFIELD MO
63005-7108
US

IV. Provider business mailing address

10 JENNYCLIFFE LN
CHESTERFIELD MO
63005-7108
US

V. Phone/Fax

Practice location:
  • Phone: 913-626-2025
  • Fax:
Mailing address:
  • Phone: 913-626-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2011007279
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: