| NPI | 1235601949 |
|---|---|
| Former Name | JOLENE BENNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5011288) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011288) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5011288) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5011288) | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2023-01-11 |