Individual
DEBRA EILEEN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9850 GENESEE AVE, SUITE 570, LA JOLLA, CA 92037-1224
(858) 200-3007
Mailing address
3554 BACONTREE PL, SAN DIEGO, CA 92111-4728
(619) 540-0283
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22962
CA
Other
Enumeration date
04/14/2013
Last updated
04/14/2013
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