Doctor Name: | MRS. CRISTA MARIE BENNETT |
NPI Number: | 1053315689 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | OA000896 |
Business Practice Address: | 1095 Million Dollar Hwy Saint Marys, PA - 158572743 |
Business Phone Number: | 8147813316 |
Business Fax Number: | 8148343317 |
Mailing Address: | 100 Hospital Ave, DU BOIS |
State: | PA |
Postal Code: | 158011440 |
Phone Number: | 8143754200 |
Fax Number: | 8143754232 |
NPI Enumeration Date: | 06/10/2005 |
NPI Last Update Date: | 03/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | OA000896 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |