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General NPI Number Information
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NPI Number | 1740218791
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Entity Type | Individual
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Provider Name | LISA M BENNETT CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 1707 LAKE LANSING RD
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City | LANSING
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State | MI
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Zip | 48912-3742
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Country | US
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Telephone | 517-332-1200
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Fax | 517-351-7122
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Provider Business Mailing Address
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Address Line | 1701 SOUTH BLVD E STE 300
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6120
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Country | US
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Telephone | 248-884-9710
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Fax | 248-884-9711
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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 | 4704205789
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License Number State | MI
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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 | RN-324508
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R0134240
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License Number State | OK
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