Individual
LISA M BENNETT
Active
Individual
LISA M BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704205789
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
R0134240
OK
367500000X
Certified Registered Nurse Anesthetist
RN-324508
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200879670A
—
OK
01
—
4704205789
MICHIGAN BOARD OF NURSING
MI
01
—
R0134240
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
06/29/2006
Last updated
10/13/2022
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