MEDICARE: VANCE BENNETT NP

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
1	363LF0000X	Family Nurse Practitioner	RN10010927	MA
2	363LF0000X	Family Nurse Practitioner	95037298	CA

General Provider Information

NPI Number	:	1427895515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANCE BENNETT NP

Provider Business Mailing Address
First Line	:	280 CHESTNUT ST FL 2
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:	413-794-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	23625 HOLMAN HWY
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5902
Country	:	US
Telephone Number	:	831-624-5311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	02/13/2026

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