Individual
KELLY ANN BENNETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7814 BUCKSKIN DR, SHEPHERD, MT 59079-4521
(406) 500-1858
Mailing address
PO BOX 101, SHEPHERD, MT 59079-0101
(406) 500-1858
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-219555
MT
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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