Bennett, Regina M

Bennett, Regina M is an individual health care provider with primary practice located at 200 W. Hospital Dr. , Whiteriver AZ 85941-0860. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bennett, Regina M can be contacted via phone (928) 338-4911.

Contact Information

Primary practice address
200 W. Hospital Dr. Whiteriver AZ 85941-0860
Phone: (928) 338-4911
Fax: (928) 338-5508
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 332949 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP1220062 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 227601 Georgia

Profile Details

NPI number 1912995010
LBN Legal business name Bennett, Regina M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Mar 5th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912995010 NPPES
Florida MEDICAID 308463900

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