| NPI | 1174875827 |
|---|---|
| Former Name | SHANNON BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4416) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 99055) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2022-04-20 |