Active NPI
Dayna Natalia Bennett, FNP-C
- Family Nurse Practitioner
- Waterford, MI
National Provider Identifier
1689158651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704266910
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704266910 | MI | MD | Family 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.