Individual
BROOKE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6265 ROCK CHALK DR STE 2700, LAWRENCE, KS 66049-5232
(785) 505-5885
Mailing address
325 MAINE ST, LAWRENCE, KS 66044-1360
(785) 505-2988
(785) 505-5228
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1501950
KS
363AM0700X
Medical Physician Assistant
Primary
2018033452
MO
Other
Enumeration date
08/18/2016
Last updated
05/12/2026
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