Bennett, Shanon Dione

Bennett, Shanon Dione is an individual health care provider with primary practice located at 1731 W Ridgeway Ave Ste 100 , Waterloo IA 50701-4591. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Bennett, Shanon Dione can be contacted via phone (319) 833-5888.

Contact Information

Primary practice address
1731 W Ridgeway Ave Ste 100 Waterloo IA 50701-4591
Phone: (319) 833-5888
Fax: (319) 833-5891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001000136 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 001016 Iowa

Profile Details

NPI number 1013979079
LBN Legal business name Bennett, Shanon Dione
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Jul 21st, 2022 - about 3 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 1013979079 NPPES
Iowa Other 970024832 RR MEDICARE

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