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General NPI Number Information
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NPI Number | 1295595106
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Entity Type | Organization
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Legal Business Name | BENNETT SUPPLY AND SERVICES LLC
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 245 N WACO ST STE 220
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City | WICHITA
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State | KS
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Zip | 67202-1102
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Country | US
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Telephone | 316-722-2138
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Fax | 833-464-2530
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Provider Business Mailing Address
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Address Line | 245 N WACO ST STE 220
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City | WICHITA
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State | KS
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Zip | 67202-1102
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Country | US
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Telephone | 316-722-2138
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Fax | 800-735-8893
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Authorized Official
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Title or Position | OWNER
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Name | DAWNELE D TAYLOR
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Credential | APRN
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Telephone | 316-393-5256
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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 |
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License Number State |
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