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NPI Code Detail

MEDICARE: MS. DIANE T BENNETT CNP

MEDICARE: MS. DIANE T BENNETT CNP
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 PractitionerNP06886OH

General Provider Information

NPI Number : 1952302903
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE T BENNETT CNP
Provider Business Mailing Address
First Line : 908 N 6TH ST
Second Line :
City : CAMBRIDGE
State : OH
Zip : 43725
Country : US
Telephone Number : 740-680-8289
Fax Number :
Provider Business Practice Location Address
First Line : 4055 VALLEY VIEW LN STE 400
Second Line :
City : DALLAS
State : TX
Zip : 75244-5071
Country : US
Telephone Number : 877-570-9359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 06/17/2020

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