| NPI | 1528292992 | 
|---|---|
| Former Name | JOHNETTA BENNEFIELD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians | 
| Enumeration Date | 2009-05-13 | 
| Last Update Date | 2023-04-25 |