Bennett, Lisa G

Bennett, Lisa G is an sole proprietor health care provider with primary practice located at 1602 Harper Rd , Beckley WV 25801-3310. 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, Lisa G can be contacted via phone (304) 252-8531.

Contact Information

Primary practice address
1602 Harper Rd Beckley WV 25801-3310
Phone: (304) 252-8531
Fax: (304) 252-0466
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 52885 West Virginia

Profile Details

NPI number 1760477947
LBN Legal business name Bennett, Lisa G
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2005
Last updated Jul 8th, 2007 - about 19 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 1760477947 NPPES
West Virginia MEDICAID 38100003317

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