Individual
KELLY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CRNA
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 787-4000
Mailing address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(443) 844-5034
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R222937
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
R222937
MD
Other
Enumeration date
06/01/2023
Last updated
03/11/2024
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