Chevelle Antionette Bennett, NURSE (LPN)

Individual provider Active NPI Licensed Practical Nurse · Moraine, OH

NPI 1013406040 · NPPES record last updated Apr 7, 2026

Key facts

NPI
1013406040
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN.160731.M-IV (OH)
Practice address
4964 Springboro Pike
Moraine, OH 45439-1940
Phone
(937) 856-9576
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN.160731.M-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hearts of Passion HHC LLC Current
since Jan 31, 2021
Accepting new patients

Locations

4964 Springboro Pike
Moraine, OH 45439
Phone (937) 856-9576

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.160731.M-IV OH Yes

Addresses

Primary practice location

4964 Springboro Pike
Moraine, OH 45439-1940

Mailing address

4964 Springboro Pike
Moraine, OH 45439-1940
Phone (937) 949-8716

Other providers in Moraine, OH

All providers in Moraine, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.