| NPI | 1073066544 |
|---|---|
| Former Name | SHELBY ANN BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 16681) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2016030998) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: NE 16681) | |
| 183500000X Pharmacist (Licence: IA 23010) | |
| 183500000X Pharmacist (Licence: KS 1-100585) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-01-09 |