Provider Demographics
NPI:1619734589
Name:BENNETT, KARA LYNN
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LYNN
Last Name:BENNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 FRANK BROWN RD
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-5689
Mailing Address - Country:US
Mailing Address - Phone:304-719-6240
Mailing Address - Fax:
Practice Address - Street 1:68 FRANK BROWN RD
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-5689
Practice Address - Country:US
Practice Address - Phone:304-719-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant