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NPI Code Detail

MEDICARE: HALLIE BENNETT

MEDICARE: HALLIE BENNETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1326901968
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALLIE BENNETT
Provider Business Mailing Address
First Line : 6532 E 27TH ST
Second Line :
City : TULSA
State : OK
Zip : 74129-6110
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1728 S CARSON AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4610
Country : US
Telephone Number : 918-936-6127
Fax Number : 999-999-9999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ HALLIE BENNETT ” Practice Location

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