Provider Demographics
NPI:1033469697
Name:BENNETT, MORGAN S (BSN, RN)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:S
Last Name:BENNETT
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 PARFET ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5574
Mailing Address - Country:US
Mailing Address - Phone:303-239-7071
Mailing Address - Fax:303-239-7157
Practice Address - Street 1:645 PARFET ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5574
Practice Address - Country:US
Practice Address - Phone:303-239-7071
Practice Address - Fax:303-239-7157
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO205458163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO39256740Medicaid