Individual
MRS. KINNEATHEA DENISHA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
5414 FREDERICKSBURG RD STE 100A, SAN ANTONIO, TX 78229-3641
(210) 468-0800
(210) 733-8649
Mailing address
500 KIRTS BLVD STE 100, TROY, MI 48084-4135
(248) 824-6623
(866) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP133353
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370823204
—
TX
01
—
AG0117008
AMERICAN ACADEMY OF NURSE PRACTITIONERS
TX
Enumeration date
03/07/2017
Last updated
09/29/2022
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