Individual provider · Type 1 NPI
Nicole Andrea Bennett, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · East Alton, IL
NPI number
1679163372
Active
Practice location
2 Terminal Dr Ste 8
East Alton, IL 62024-2294
Fax (618) 259-2495
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 2018036588 (MO) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 209030085 (IL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1679163372
Nicole Andrea Bennett, PMHNP-BC's National Provider Identifier is 1679163372, issued on Jan 26, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in East Alton, IL. The record was last updated on Aug 7, 2024.