Individual provider · Type 1 NPI

Mary Keely Costello Bennett, AGACNP-BC

Acute Care Nurse Practitioner · Richmond, VA

NPI number 1417398124 Active

Practice location

1250 E Marshall St, Emergency Medicine
Richmond, VA 23298-5051

Call (804) 828-5650 Map

Fax (804) 828-4686

Mailing address

PO Box 91734
Richmond, VA 23291-1734

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100X0024170989 (VA)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1417398124

Mary Keely Costello Bennett, AGACNP-BC's National Provider Identifier is 1417398124, issued on Jul 10, 2013. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Richmond, VA. The record was last updated on Feb 7, 2019.