Individual
MICHAEL SCOTT BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.N., R.N., C.N.P.
Contact information
Practice address
3605 WARRENSVILLE CENTER RD, 2362-H, SHAKER HEIGHTS, OH 44122-5203
(216) 952-0955
Mailing address
13085 GAR HWY, CHARDON, OH 44024-9206
(773) 307-8500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.388869-COA1
OH
363LA2200X
Adult Health Nurse Practitioner
COA.14306-NP
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
COA.14306-NP
OH
Other
Enumeration date
05/02/2013
Last updated
01/15/2021
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