Individual
MS. JO ELLEN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2173A CENTERVILLE PL, TALLAHASSEE, FL 32308-4356
(850) 385-0144
(850) 385-0146
Mailing address
PO BOX 452198, SUNRISE, FL 33345-2198
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP2604452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G2471
BCBS OF FL
FL
Enumeration date
11/21/2005
Last updated
10/15/2007
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