Individual
PENNY R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-4007
(682) 885-4004
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
224495
TX
Other
Enumeration date
06/18/2007
Last updated
07/29/2016
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