| NPI | 1902334659 |
|---|---|
| Former Name | JESSICA L BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71007183A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28216483A) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2024-10-01 |