Basic Information
| Provider Information | |||||||||
| NPI: | 1073886222 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENNETT | ||||||||
| FirstName: | BETTY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3525 PRYTANIA ST | ||||||||
| Address2: | SUITE 526 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5046482541 | ||||||||
| FaxNumber: | 5048997828 | ||||||||
| Practice Location | |||||||||
| Address1: | 3525 PRYTANIA ST | ||||||||
| Address2: | SUITE 526 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5046482541 | ||||||||
| FaxNumber: | 5048997828 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2012 | ||||||||
| LastUpdateDate: | 04/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | RN043542 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.