Individual
MR. JUSTIN M BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
567 WALKER ST, MERRYVILLE, LA 70653-3040
(337) 825-1728
(337) 825-1229
Mailing address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 365-4945
(337) 376-6860
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04254
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477095
—
LA
Enumeration date
08/26/2005
Last updated
10/17/2019
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