Individual
KIANA ELNORA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1436 41ST ST SE, WASHINGTON, DC 20020-6002
(301) 213-6112
Mailing address
1436 41ST ST SE, WASHINGTON, DC 20020-6002
(301) 213-6112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08491
MD
Other
Enumeration date
01/05/2022
Last updated
08/29/2022
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