Tammy Rene Bennett, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN072119 Issued in LA

Practice address

1525 Fairfield Ave Ste 569
Office of Public Health
Shreveport, LA 71101-4331

Phone

(318) 676-7483

Fax

(318) 676-7560

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1942220959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 SR 333",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728020963",
            "telephone_number": "318-470-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 FAIRFIELD AVE STE 569",
            "address_2": "OFFICE OF PUBLIC HEALTH",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014331",
            "telephone_number": "318-676-7483",
            "fax_number": "318-676-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TAMMY",
        "middle_name": "RENE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN072119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1435074",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Bennett
• Katrina Bennett
• Patrice Bennett
• Ratonya Bennett
• Sharnell Bennett
• Theresa Bennett
• Amanda Benson, LOTR
• Jordan Benson, OTR
• Sarah Berdiner
• Joel Berends, MD

• Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.