NPI 1174293138 · live from the CMS NPI Registry
Justin Baines Bennett
Nurse Practitioner, Family in Williamstown, WV. National Provider Identifier 1174293138, active.
NPI record
| NPI | 1174293138 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 4314 Williamstown Pike, Williamstown, WV 26187 |
| Practice phone | 304-482-6029 |
| Enumerated | September 20, 2021 |
| Last updated | February 9, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Home Health | 163WH0200X | RN.385551 (OH) |
| Family Medicine | 207Q00000X | LE-00038485 (OH) |
| Nurse Practitioner, Family primary | 363LF0000X | 110892 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.