Individual
MS. KATHY JO BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 WYOMING ST, DAYTON, OH 45409-2722
(937) 208-8000
Mailing address
1 WYOMING ST, DAYTON, OH 45409-2722
(937) 208-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
206624
TN
363LA2100X
Acute Care Nurse Practitioner
71003950A
IN
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
279294
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201069120
—
IN
Enumeration date
06/01/2011
Last updated
10/03/2025
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