Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 71000710A | IN |
NPI | 1023025665 |
---|---|
Provider Name | Sheri Stohler Bennett |
First Address | Muncie, IN 47308-1643 |
Second Address | Muncie, IN 47304-5407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 27/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000283939 | ANTHEM PIN (01) | IN |
200227810 | (05) | IN |
500013875 | RAILROAD MEDICARE (01) | IN |
S87794 | (02) | IN |