Lora Jean Bennett, LPN
Individual provider Active NPI Licensed Practical Nurse · Bellbrook, OH
NPI 1497970693 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1497970693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN106887 (OH)
- Practice address
- 2365 Sullivan Dr
Bellbrook, OH 45305-1743 - Phone
- (937) 848-4167
- Fax
- (937) 848-4167
- NPI assigned
- Apr 16, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN106887 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN106887 | OH | Yes |
Addresses
Primary practice location
2365 Sullivan Dr
Bellbrook, OH 45305-1743
Mailing address
2365 Sullivan Dr
Bellbrook, OH 45305-1743
Phone (937) 848-4167
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2333424 | Medicaid | OH |
Other providers in Bellbrook, OH
- Beauty Mark Aesthetics
- Bellbrook Family Dentistry-John P Harmeyer, DDS LLC
- Bellbrook Medical Center
- Bellbrook Pediatric Dentistry, Inc.
- Bellbrook Sugarcreek Local Schools
- Audrey Constance Berlin
- Bio Enhancement Physical Therapy Inc
- Kimberli Suzanne Blaschak
- Eric Bletzinger
- Craig Dean Boreman
All providers in Bellbrook, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.