Doctor Name: | TAMIE BENNETT |
NPI Number: | 1487051827 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ADULT GERONTOLOGY NP |
License Number: | 5949-33 |
Business Practice Address: | 227 E Waupun St Oakfield, WI - 530659746 |
Business Phone Number: | 9205832631 |
Business Fax Number: | |
Mailing Address: | 227 E Waupun St, OAKFIELD |
State: | WI |
Postal Code: | 530659746 |
Phone Number: | 9205832631 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2014 |
NPI Last Update Date: | 12/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 5949-33 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |