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General NPI Number Information
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NPI Number | 1689510455
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Entity Type | Individual
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Provider Name | EMMA MARIE BENNETT
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Gender | Female
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 400 N INGALLS ST
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City | ANN ARBOR
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State | MI
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Zip | 48109-2003
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Country | US
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Telephone | 734-764-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 4544 LEEWARD DR
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City | PLEASANT LAKE
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State | MI
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Zip | 49272-9783
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Country | US
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Telephone | 517-745-6783
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704412941
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License Number State | MI
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