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General NPI Number Information
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NPI Number | 1982952511
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Entity Type | Individual
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Provider Name | SHERRI A BENNETT NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 1801 E LANGSFORD RD
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City | LEES SUMMIT
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State | MO
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Zip | 64063-6323
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Country | US
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Telephone | 816-605-5838
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Fax |
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Provider Business Mailing Address
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Address Line | 200 WILMOT RD
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City | DEERFIELD
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State | IL
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Zip | 60015-4620
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2012004605
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License Number State | MO
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