Individual
MOLLY NICHOLE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
729 W 35TH ST, MARION, IN 46953-4215
(765) 674-3371
Mailing address
311 E SOUTH H ST, GAS CITY, IN 46933-1848
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27067474A
IN
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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