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Individual

RENEE RACHELLE BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
417 S 6TH ST, BOISE, ID 83702-7632
(479) 755-7562
Mailing address
7230 S WIDGI AVE, BOISE, ID 83709-7394
(479) 755-7562

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201607206RN
OR
163W00000X
Registered Nurse
Primary
57148
ID

Other

Enumeration date
10/17/2024
Last updated
10/17/2024
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