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General NPI Number Information
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NPI Number | 1265492219
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Entity Type | Individual
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Provider Name | SUSAN F BENNETT CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 289 COUNTY RD
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City | WINDSOR
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State | VT
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Zip | 05089-9000
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Country | US
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Telephone | 802-674-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 148 WINDING RIVER DR
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City | MURRELLS INLET
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State | SC
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Zip | 29576-9786
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Country | US
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Telephone | 843-651-2509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 00105295
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3148
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License Number State | SC
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