Individual
MARY JANE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2415 E CAMELBACK RD STE 700, PHOENIX, AZ 85016-4245
(520) 246-3971
(833) 450-4452
Mailing address
2415 E CAMELBACK RD STE 700, PHOENIX, AZ 85016-4245
(520) 246-3971
(833) 450-4452
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A10235
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009269
KAISER-COMMERCIAL NUMBER
—
Enumeration date
03/22/2007
Last updated
06/05/2024
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