Healthcare Provider Details

I. General information

NPI: 1306792254
Provider Name (Legal Business Name): KRISTIANNA DARLENE BENTON /
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGEL BENTON

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 BROOKCREST DR STE 354
CINCINNATI OH
45237-3448
US

IV. Provider business mailing address

2232 SAINT JAMES AVE
CINCINNATI OH
45206-3107
US

V. Phone/Fax

Practice location:
  • Phone: 513-802-5642
  • Fax:
Mailing address:
  • Phone: 513-802-5642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: