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NPI Code Detail

MEDICARE: MS. ANGELICA MARIE BENNETT APRN

MEDICARE:  MS. ANGELICA MARIE BENNETT  APRN
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
1363LF0000XFamily Nurse Practitioner2025094190MO

General Provider Information

NPI Number : 1366399792
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELICA MARIE BENNETT APRN
Provider Business Mailing Address
First Line : 2024 DORSETT VLG
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2208
Country : US
Telephone Number : 314-590-0550
Fax Number :
Provider Business Practice Location Address
First Line : 2024 DORSETT VLG
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2208
Country : US
Telephone Number : 314-590-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2026
Last Update Date : 03/13/2026

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Directions to “ MS. ANGELICA MARIE BENNETT APRN” Practice Location

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