Individual
KRISTIN MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
7 SEAFIELD LN, WESTHAMPTON BEACH, NY 11978-2719
(631) 288-1122
Mailing address
11 RUTH LN, RIDGE, NY 11961-2629
(631) 827-0967
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
538604
NY
363L00000X
Nurse Practitioner
Primary
F352901-01
NY
Other
Enumeration date
09/05/2023
Last updated
10/16/2024
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