Provider Demographics
NPI:1831514389
Name:BENNET, ELIZABETH WEILAND (MSN, RN, CPNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WEILAND
Last Name:BENNET
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:WEILAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1533 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3803
Mailing Address - Country:US
Mailing Address - Phone:216-228-6663
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DR.
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109
Practice Address - Country:US
Practice Address - Phone:216-778-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN279694-COA1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics