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Individual

MRS. CRISTA MARIE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1100 MILLION DOLLAR HWY, SAINT MARYS, PA 15857-2728
(814) 781-6758
(814) 781-3317
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6549
(814) 372-2864

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053375
PA
363AM0700X
Medical Physician Assistant
OA000896
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
341440FFU
MEDICARE PTAN
PA
Enumeration date
06/10/2005
Last updated
12/10/2020
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