Doctor Name: | DONNA MARLANE BENNETT |
NPI Number: | 1043360217 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 329221 |
Business Practice Address: | 845 S Fairmont Ave #8 Lodi, CA - 952405113 |
Business Phone Number: | 2093397633 |
Business Fax Number: | |
Mailing Address: | 523 Olive Ct, LODI |
State: | CA |
Postal Code: | 952401044 |
Phone Number: | 2093397633 |
Fax Number: | |
NPI Enumeration Date: | 01/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0106X |
License Number: | 329221 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Occupational Health |
Taxonomy Definition: |