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Individual

MRS. SUSAN M BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1907
(570) 326-8470
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP014041
PA
363LA2200X
Adult Health Nurse Practitioner
SP014041
PA

Other

Enumeration date
07/28/2014
Last updated
02/21/2022
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