NPI Profile for JUSTIN M BENNETT in MERRYVILLE, LA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1386637155 |
|
| Status | Active | |
| Credentials | NP (Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 08/26/2005 | |
| Last updated | 10/17/2019 - About 7 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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JUSTIN M BENNETT
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