| Doctor Name: | MARIE G BENNETT |
| NPI Number: | 1215376405 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | RN2265713 |
| Business Practice Address: | 200 Groton Rd Ayer, MA - 014321168 |
| Business Phone Number: | 9787849000 |
| Business Fax Number: | |
| Mailing Address: | 819 Worcester St, Ste 3 SPRINGFIELD |
| State: | MA |
| Postal Code: | 011511045 |
| Phone Number: | 4135436820 |
| Fax Number: | 4135437962 |
| NPI Enumeration Date: | 06/20/2013 |
| NPI Last Update Date: | 03/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN2265713 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |