Individual
DEANNA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
71 US ROUTE 1 STE A, SCARBOROUGH, ME 04074-7168
(207) 885-8400
Mailing address
71 US ROUTE 1 STE A, SCARBOROUGH, ME 04074-7168
(207) 885-8400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R048217
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R048217
STATE LICENSE
ME
Enumeration date
06/23/2006
Last updated
12/27/2023
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