Provider Demographics
NPI:1174654958
Name:BENNETT, ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 CHILI AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3035
Mailing Address - Country:US
Mailing Address - Phone:585-235-1514
Mailing Address - Fax:585-235-4186
Practice Address - Street 1:1160 CHILI AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-3035
Practice Address - Country:US
Practice Address - Phone:585-235-1514
Practice Address - Fax:585-235-4186
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330535-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily