Provider Demographics
NPI:1548351984
Name:BENNETT, KAREN SUE (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:BENNETT-DREFS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6715 LARKSPUR RD
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-3511
Mailing Address - Country:US
Mailing Address - Phone:401-231-0008
Mailing Address - Fax:
Practice Address - Street 1:VAMC 11 IRVING ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:202-745-8579
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR097927163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse