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Individual

LORI JOY BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS FNP

Contact information

Practice address
2364 BISHOP AVE, ANN ARBOR, MI 48105-2248
(734) 647-1636
(734) 763-9634
Mailing address
2364 BISHOP AVE, ANN ARBOR, MI 48105-2248
(734) 647-1636
(734) 763-9634

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
47041134489
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4110360
MI
01
5008664290
BCBS
MI
Enumeration date
08/29/2006
Last updated
07/08/2007
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