Doctor Name: | KERRI DAWN BENNING |
NPI Number: | 1285018192 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | R31077 |
Business Practice Address: | 104 Main Street Turtle Lake, ND - 58575 |
Business Phone Number: | 7014489244 |
Business Fax Number: | 7014482056 |
Mailing Address: | Po Box 535, TURTLE LAKE |
State: | ND |
Postal Code: | 585750535 |
Phone Number: | 7014489244 |
Fax Number: | 7014482056 |
NPI Enumeration Date: | 07/10/2015 |
NPI Last Update Date: | 07/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R31077 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |