Individual
SARAH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24276 166TH ST AIRPORT RD, EAGLE BUTTE, SD 57625
(605) 964-0569
Mailing address
24276 166TH ST AIRPORT RD, EAGLE BUTTE, SD 57625
(605) 964-0569
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
894045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
894045
IHS
TX
Enumeration date
02/01/2021
Last updated
02/01/2021
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