Individual
ELIZABETH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8450 SEASONS PKWY, WOODBURY, MN 55125-4402
(952) 853-8800
Mailing address
3532 IRVING AVE S UPPR, MINNEAPOLIS, MN 55408-3324
(252) 292-6161
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11114
MN
363AM0700X
Medical Physician Assistant
01310
NC
Other
Enumeration date
05/01/2008
Last updated
04/04/2023
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