Provider Demographics
NPI:1801104526
Name:BENNETT, YOLANDA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 E STATE HWY 121
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6891
Mailing Address - Country:US
Mailing Address - Phone:972-745-7500
Mailing Address - Fax:972-745-4336
Practice Address - Street 1:345 N HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2134
Practice Address - Country:US
Practice Address - Phone:972-956-5300
Practice Address - Fax:972-956-5393
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR863817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00675527Medicaid
MS30250I0194Medicare PIN
MS251933Medicare Oscar/Certification
MSCC2133Medicare Oscar/Certification
MS251850Medicare Oscar/Certification
MS251936Medicare Oscar/Certification
MS00675527Medicaid
MS326465YJ5DMedicare PIN