Individual provider · NPI-1

Deirdre L Bennett, NP, CNM

Nurse Practitioner, Family · Portland, ME

NPI number1952318339
StatusActive
Last updated in NPPESFeb 13, 2013

Details

NPI
1952318339
Entity type
Individual (NPI-1)
Name
Deirdre L Bennett
Credential
NP, CNM
Sex
Female
Sole proprietor
No
Enumeration date
Aug 1, 2006
Last updated
Feb 13, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyCNP81541MEYes
367A00000X Advanced Practice MidwifeCNM82024ME

Practice location

22 Bramhall St
Maine Medical Center - Internal Medicine Clinic
Portland, ME 04102-3134

Phone 207-662-2911 · Fax 207-662-6308

Mailing address

11 Lee Ave
South Portland, ME 04106-3520

Phone 207-767-2315

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