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Individual

MS. VIRGINIA H BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNS, APRN

Contact information

Practice address
223 EAST CENTER ST, MANCHESTER, CT 06040
(860) 647-1582
(860) 647-1582
Mailing address
P.O BOX 1072, MANCHESTER, CT 06045
(860) 647-1582
(860) 647-1585

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
00173
CT
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
001713
CT
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
0281025-01
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01713
APRN
CT
01
028102501
CLINICAL SPECIAL ADULT ME
05
4200284
CT
Enumeration date
04/11/2007
Last updated
03/07/2023
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