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NPI Code Detail

MEDICARE: ANNE BENNETT CPNP

MEDICARE: ANNE BENNETT CPNP
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
1363LP0200XPediatric Nurse Practitioner2019003831MO

General Provider Information

NPI Number : 1689139503
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE BENNETT CPNP
Provider Business Mailing Address
First Line : 3340 NE AKIN BLVD APT 532
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64064-7896
Country : US
Telephone Number : 573-353-3097
Fax Number :
Provider Business Practice Location Address
First Line : 1600 NW SOUTH OUTER RD
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64015-2963
Country : US
Telephone Number : 816-524-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2019
Last Update Date : 02/05/2019

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