Bennett, Annabelle L

Bennett, Annabelle L is an individual health care provider with primary practice located at 1716 Hartford St , Lafayette IN 47904-2173. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Bennett, Annabelle L can be contacted via phone (765) 742-1567.

Contact Information

Primary practice address
1716 Hartford St Lafayette IN 47904-2173
Phone: (765) 742-1567
Fax: (765) 429-6961
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71002238A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 71002238A Indiana

Profile Details

NPI number 1609916394
LBN Legal business name Bennett, Annabelle L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated Nov 7th, 2011 - about 13 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 1609916394 NPPES
Indiana Other 71002238A ST. LICENSE
Indiana MEDICAID 2008455550 ST. LICENSE

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