Individual provider Active NPI

Dayna Natalia Bennett, FNP-C

  • Family Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1689158651
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704266910 Issued in MI
Practice address
2111 Pontiac Lake Rd
Waterford, MI 48328-2736
Phone
(947) 500-1691
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704266910 MI Primary

Addresses

Primary practice location

2111 Pontiac Lake Rd
Waterford, MI 48328-2736

Mailing address

1250 Kinlock Dr
Troy, MI 48098-2027
Phone (248) 660-7882

Other practice location 1

719 S Opdyke Rd
Auburn Hills, MI 48326-3436
Phone (248) 333-3250

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704266910MIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1689158651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 KINLOCK DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982027",
            "telephone_number": "248-660-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282736",
            "telephone_number": "947-500-1691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 S Opdyke Rd",
            "address_purpose": "LOCATION",
            "city": "Auburn Hills",
            "state": "MI",
            "postal_code": "483263436",
            "country_code": "US",
            "telephone_number": "248-333-3250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "DAYNA",
        "middle_name": "NATALIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704266910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.