Provider Demographics
NPI:1083015242
Name:BENNETT, ARLON HARRIS (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ARLON
Middle Name:HARRIS
Last Name:BENNETT
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 27TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-5128
Mailing Address - Country:US
Mailing Address - Phone:406-721-4540
Mailing Address - Fax:406-721-1838
Practice Address - Street 1:2230 27TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-5128
Practice Address - Country:US
Practice Address - Phone:406-721-4540
Practice Address - Fax:406-721-1838
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTF0814197363LF0000X
MT100595363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily