Mrs. Krista R Bennett
Sports Medicine Doctor
5050 N Clinton St
Fort Wayne
, Indiana 46825-5822
Mrs. Krista R Bennett
Sports Medicine Doctor
5050 N Clinton St
Fort Wayne
, Indiana 46825-5822
(260) 497-9529
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Mrs. Krista R Bennett
- 726 Sunturn Dr
- Fort Wayne, IN
- Zip : 46825-2295
- Phone : (260) 497-9529
Second Address
- Mrs. Krista R Bennett
- 5050 N Clinton St
- Fort Wayne, IN
- Zip : 46825-5822
- Fax : (260) 484-3351
- Phone : (260) 484-8551
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | 36000834A | IN |
National Provider Identifier
| NPI | 1225091705 |
|---|---|
| Provider Name | Mrs. Krista R Bennett |
| First Address | Fort Wayne, IN 46825-2295 |
| Second Address | Fort Wayne, IN 46825-5822 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/04/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.