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Individual

ROSEMARY HEATHER BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
414 N 2ND ST, JEFFERSON, OR 97352-9706
(503) 374-4343
Mailing address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
200842417RN
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200842417RN
OSBN
OR
Enumeration date
09/10/2021
Last updated
09/10/2021
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