Provider Demographics
NPI:1083870851
Name:BENNETT, FAITH DALEY (RN)
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:DALEY
Last Name:BENNETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 64TH PL N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-6346
Mailing Address - Country:US
Mailing Address - Phone:727-403-3788
Mailing Address - Fax:
Practice Address - Street 1:2724 64TH PL N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-6346
Practice Address - Country:US
Practice Address - Phone:727-403-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL896532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse