Individual
ASHLEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3111 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5235
(618) 997-3647
(618) 959-9437
Mailing address
2914 N PARK AVE, HERRIN, IL 62948-3522
(618) 925-7790
(844) 270-4161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.445121
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.032324
IL
Other
Enumeration date
03/29/2018
Last updated
10/23/2025
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