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Individual

NORA BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 222-1816
(651) 602-7517
Mailing address
174 CARLSON LN, RIVER FALLS, WI 54022-8102

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
104962-0
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0105294
MEDICA
MN
01
150768
UCARE
MN
05
230662000
MN
01
29D61BE
BCBS
MN
01
923911025969
PREFERRED ONE
MN
01
HP31361
HEALTH PARTNERS
MN
Enumeration date
03/29/2006
Last updated
02/24/2010
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