Debra Dawn Bennett, RN
Individual provider Active NPI Registered Nurse · Clarksburg, WV
NPI 1194054486 · NPPES record last updated Dec 15, 2009
Key facts
- NPI
- 1194054486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 52372 (WV)
- Practice address
- RR 1 Box 507
Clarksburg, WV 26301-9765 - Phone
- (304) 624-4064
- NPI assigned
- Dec 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52372 | WV | MD | Emergency Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 52372 | WV | Yes |
| Emergency Registered Nurse | 163WE0003X | 52372 | WV |
Addresses
Primary practice location
RR 1 Box 507
Clarksburg, WV 26301-9765
Mailing address
RR 1 Box 507
Clarksburg, WV 26301-9765
Phone (304) 624-4064
Other providers in Clarksburg, WV
- Billiee Bell
- Samuel J Bellotte
- Benchmark Therapy, Inc
- Carol Louise Bennett
- Darral N Bennett Jr.
- Hollie Bennett
- Kimberly Ann Bennett
- Lauren Bennett
- N'Shay Bennett
- Tina Bennett
All providers in Clarksburg, WV · Registered Nurse in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.