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General NPI Number Information
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NPI Number | 1780476440
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Entity Type | Individual
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Provider Name | SANDRA BENNETT
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 3425 36TH RD
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City | SILVER CREEK
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State | NE
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Zip | 68663-3704
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Country | US
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Telephone | 308-773-2519
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Fax |
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Provider Business Mailing Address
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Address Line | 9679 13TH AVE
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City | COLUMBUS
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State | NE
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Zip | 68601-8213
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Country | US
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Telephone | 402-366-3067
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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