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NPI Code Detail

MEDICARE: SUSAN ELIZABETH BENNETT

MEDICARE:   SUSAN ELIZABETH 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
1363LF0000XFamily Nurse Practitioner44573KS
2363LF0000XFamily Nurse Practitioner112431MO

General Provider Information

NPI Number : 1689709503
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ELIZABETH BENNETT
Provider Business Mailing Address
First Line : 901 W 112TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64114-5205
Country : US
Telephone Number : 816-942-5886
Fax Number :
Provider Business Practice Location Address
First Line : 2901 ROCKCREEK PKWY
Second Line :
City : KANSAS CITY
State : MO
Zip : 64117-2536
Country : US
Telephone Number : 816-201-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 09/03/2019

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Directions to “ SUSAN ELIZABETH BENNETT ” Practice Location

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