Basic Information
| Provider Information | |||||||||
| NPI: | 1962595884 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENDER | ||||||||
| FirstName: | JEANNE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4449 FASHION SQUARE BLVD | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486035217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897900007 | ||||||||
| FaxNumber: | 9897907441 | ||||||||
| Practice Location | |||||||||
| Address1: | 4680 MCLEOD DR E | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486042852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897919133 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 04/20/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 4704158432 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.