Individual
RUSSELL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN
Contact information
Practice address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700
Mailing address
25 KESSEL CT, MADISON, WI 53711-6227
(608) 280-2700
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
90892
WI
Other
Enumeration date
04/25/2007
Last updated
09/08/2016
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