Provider Demographics
NPI:1295068591
Name:BENNETT, JOAN IRENE PERSON (DNP, FNP-BC,CRNP-F)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:IRENE PERSON
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DNP, FNP-BC,CRNP-F
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Other - First Name:
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Mailing Address - Street 1:103 CHESAPEAKE PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-4201
Mailing Address - Country:US
Mailing Address - Phone:410-682-1595
Mailing Address - Fax:410-682-2538
Practice Address - Street 1:103 CHESAPEAKE PARK PLZ
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-4201
Practice Address - Country:US
Practice Address - Phone:410-682-1595
Practice Address - Fax:410-682-2538
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR152891363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner