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Individual
LINDA S BENNETT
Active
Individual
LINDA S BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9455
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0671F
BCBS ID
NC
01
—
0784P
BCBS GROUP
NC
01
—
2503655
MEDICARE GROUP
NC
01
—
2509457
MEDICARE ID
NC
01
—
4495020001
DME MEDICARE
NC
01
—
7200002
MEDICAID GROUP
NC
01
—
720784P
MEDICAID GROUP
NC
05
—
7212104
—
NC
01
—
DF4857
RR MEDICARE GROUP
NC
01
—
P00369642
RR MEDICARE PIN
NC
Enumeration date
12/28/2005
Last updated
10/05/2009
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