Individual
LAUREN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 576-8529
Mailing address
4100 JOHN R ST, DETROIT, MI 48201-2013
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704270449
MI
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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