Individual
SHERRI A BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1801 E LANGSFORD RD, LEES SUMMIT, MO 64063-6323
(816) 605-5838
Mailing address
200 WILMOT RD, DEERFIELD, IL 60015-4620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2012004605
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195877758
—
AR
05
—
1982952511
—
MO
01
—
431560263
TRICARE
MO
01
—
P01128075
RR MCR
MO
Enumeration date
08/29/2012
Last updated
01/12/2016
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