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General NPI Number Information
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NPI Number | 1972826659
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Entity Type | Individual
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Provider Name | HOLLY E BENNETT APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 5635 N MLK JR BLVD
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City | TULSA
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State | OK
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Zip | 74126-6409
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Country | US
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Telephone | 918-398-9460
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Fax | 918-992-2822
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Provider Business Mailing Address
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Address Line | 5635 N MLK JR BLVD STE 270
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City | TULSA
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State | OK
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Zip | 74126-6409
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Country | US
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Telephone | 918-398-9460
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Fax | 918-392-7013
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 116005
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024168706
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License Number State | VA
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