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Individual

MS. KATRINA K BENTLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, CNS, NP-C

Contact information

Practice address
365 CENTER ROAD, GRANGEVILLE, ID 83530-1917
(208) 983-5535
(208) 983-5575
Mailing address
PO BOX 145, GRANGEVILLE, ID 83530-0145
(208) 983-5535
(208) 983-5575

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-527A
ID

Other

Enumeration date
12/29/2005
Last updated
07/09/2007
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