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NPI Code Detail

MEDICARE: EMILY NATOSHA BENNETT APRN

MEDICARE:   EMILY NATOSHA 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
1363LG0600XGerontology Nurse PractitionerAP144518TX

General Provider Information

NPI Number : 1992325906
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY NATOSHA BENNETT APRN
Provider Business Mailing Address
First Line : 1140 BUSINESS CENTER DR STE 202
Second Line :
City : HOUSTON
State : TX
Zip : 77043-2741
Country : US
Telephone Number : 713-800-0660
Fax Number : 713-827-1380
Provider Business Practice Location Address
First Line : 1631 NORTH LOOP W STE 410
Second Line :
City : HOUSTON
State : TX
Zip : 77008-1530
Country : US
Telephone Number : 713-802-9000
Fax Number : 713-802-2701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2020
Last Update Date : 10/05/2022

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Directions to “ EMILY NATOSHA BENNETT APRN” Practice Location

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