Provider Demographics
NPI:1982321295
Name:BENTLEY, DENARIKA (CPE,CD,PCD)
Entity Type:Individual
Prefix:
First Name:DENARIKA
Middle Name:
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:CPE,CD,PCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 STANDIFER GAP RD APT 1009
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1183
Mailing Address - Country:US
Mailing Address - Phone:423-833-1780
Mailing Address - Fax:
Practice Address - Street 1:7604 STANDIFER GAP RD APT 1009
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1183
Practice Address - Country:US
Practice Address - Phone:423-833-1780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty