Individual
JACKLYN BROOKE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1035 CONSTITUTION AVE, ELLWOOD CITY, PA 16117-3234
(724) 714-8439
Mailing address
1035 CONSTITUTION AVE, ELLWOOD CITY, PA 16117-3234
(724) 714-8439
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP029854
PA
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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