Individual
MISS HOLLY D. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.APN,C.
Contact information
Practice address
310 CHRIS GAUPP DR, SUITE 102, GALLOWAY, NJ 08205-4461
(609) 652-9933
(609) 652-9955
Mailing address
310 CHRIS GAUPP DR, SUITE 102, GALLOWAY, NJ 08205-4461
(609) 652-9933
(609) 652-9955
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00322500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
195242
MEDICARE P10
NJ
Enumeration date
05/13/2011
Last updated
05/13/2011
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