Individual
BRIANA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101278120
VA
207P00000X
Emergency Medicine Physician
Primary
83970
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100277552
—
WI
Enumeration date
04/21/2020
Last updated
11/26/2024
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