| NPI | 1245560242 |
|---|---|
| Former Name | MELISSA MARIE BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 336151) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 605446) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2019-09-23 |