Joan Irene Person Bennett, DNP, FNP-BC,CRNP-F

Individual provider Active NPI Nurse Practitioner · Middle River, MD

NPI 1295068591 · NPPES record last updated Nov 16, 2021

Key facts

NPI
1295068591
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
R152891 (MD)
Practice address
103 Chesapeake Park PLZ
Middle River, MD 21220-4201
Phone
(410) 682-1595
Fax
(410) 682-2538
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R152891 MD Yes

Addresses

Primary practice location

103 Chesapeake Park PLZ
Middle River, MD 21220-4201

Mailing address

103 Chesapeake Park PLZ
Middle River, MD 21220-4201
Phone (410) 682-1595

Other providers in Middle River, MD

All providers in Middle River, MD · Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.