Individual
ERIN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113
(801) 662-1000
Mailing address
1563 ALVAMAR CT, LAWRENCE, KS 66047-1713
(785) 865-9980
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
8771414-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/20/2012
Last updated
07/16/2018
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