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1013503630
MICHELLE L BENNETT
ROCKFORD, IL
NPI
1013503630
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209-022307)
Enumeration Date
2020-12-17
Last Update Date
2021-04-19
Business Address
MICHELLE L BENNETT APRN
3505 N BELL SCHOOL RD
ROCKFORD, IL 61114-6624
Phone number: 779-696-0300
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Mailing Address
MICHELLE L BENNETT APRN
PO BOX 78866
MILWAUKEE, WI 53278-8866
Phone number: 779-696-7150
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