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REGINA M BENNETT NP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1912995010
Individual Registrant: REGINA M BENNETT NP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
200 W. HOSPITAL DR. WHITERIVER, AZ 85941-0860 US
Tel: 928-338-4911 Fax: 928-338-5508
Tel: 928-338-4911 Fax: 928-338-5508
Contact information for business:
PO BOX 860 WHITERIVER, AZ 85941-0860 US
Tel: 928-338-4911 Fax: 928-338-5508
Tel: 928-338-4911 Fax: 928-338-5508
Registration Information:
NPI: 1912995010
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | NY | 332949 |
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | FL | ARNP1220062 |
| N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | GA | 227601 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 308463900 | FL | 05 |
