Bennett, Kathy Jo

Bennett, Kathy Jo is an individual health care provider with primary practice located at 1 Wyoming St , Dayton OH 45409-2722. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine is her primary health care specialty. Bennett, Kathy Jo can be contacted via phone (937) 208-8000.

Contact Information

Primary practice address
1 Wyoming St Dayton OH 45409-2722
Phone: (937) 208-8000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X 279294 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71003950A Indiana

Profile Details

NPI number 1871887463
LBN Legal business name Bennett, Kathy Jo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2011
Last updated Jan 3rd, 2013 - 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 1871887463 NPPES
Indiana MEDICAID 201069120

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