Individual
LISA G BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
212 PARK AVE, BECKLEY, WV 25801-6046
(304) 252-8551
(304) 461-1105
Mailing address
252 RURAL ACRES DR, BECKLEY, WV 25801-3503
(304) 253-2638
(304) 252-1720
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
52885
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38100003317
—
WV
Enumeration date
09/14/2005
Last updated
01/12/2025
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