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General NPI Number Information
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NPI Number | 1295068591
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Entity Type | Individual
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Provider Name | JOAN IRENE PERSON BENNETT DNP, FNP-BC,CRNP-F
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Gender | Female
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 103 CHESAPEAKE PARK PLZ
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-4201
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Country | US
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Telephone | 410-682-1595
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Fax | 410-682-2538
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Provider Business Mailing Address
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Address Line | 103 CHESAPEAKE PARK PLZ
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-4201
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Country | US
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Telephone | 410-682-1595
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Fax | 410-682-2538
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R152891
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License Number State | MD
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