Individual
GINA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E. LANCASTER AVE, ST 130, WYNNEWOOD, PA 19096
(610) 649-1175
(610) 896-8753
Mailing address
100 E. LANCASTER AVE, ST 130, WYNNEWOOD, PA 19096
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN530235L
PA
Other
Enumeration date
05/14/2015
Last updated
02/21/2019
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