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ETHAN BENNETT
Nurse Practitioner
NPI: 1285195339IndividualAccepts Medicare
Specialties, Licenses & Credentials
Registered Nurse
Registered Nurse
Code: 163W00000X
28216817A(IN)
Nurse PractitionerPrimary
Nurse Practitioner
Code: 363L00000X
71008988A(IN)
CMS Specialties
PrimaryNURSE PRACTITIONER
Education
OTHER
Class of 2019
Contact & Hours
- Address
- 11050 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845 - Phone
- (833) 724-8326
Quick Facts
- NPI
- 1285195339
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 1
- Years in Practice
- 7
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