Individual
DANECE LYNN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
426 S BLANCHE ST, MOUNDS, IL 62964-1108
(618) 745-6894
Mailing address
25431 TAMMS OLIVE BRANCH RD, TAMMS, IL 62988-3215
(573) 270-2366
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017228
IL
Other
Enumeration date
02/05/2018
Last updated
05/06/2024
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