Autumn M Bennett (NPI# 1649662578, PAC ID# 4587975016) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1649662578 |
| PAC ID by PECOS | 4587975016 |
| Professional Enrollment ID | I20150624001569 |
| Full Name | Autumn M Bennett |
| Address |
905 Borgognoni Dr Lake Village AR 71653-1623 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 041328 | CHICOT MEMORIAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2729 Hwy 65 and 82 S, Chicot Memorial Anesthesia Services, Lake Village, AR 71653-6136 | 8702655351 | CHICOT MEMORIAL MEDICAL CENTER |
| 2729 S Hwy 65 and 82, Lake Village, AR 71653-6136 | 8702655351 | CHICOT MEMORIAL MEDICAL CENTER |
| 905 Borgognoni Dr, Lake Village, AR 71653-1623 |
| Street Address |
905 BORGOGNONI DR |
| City | LAKE VILLAGE |
| State | AR |
| Zip | 71653-1623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amita N Patel | Nephrology | 1403 St Mary, Lake Village, AR 71653-0001 | |
| Mark Robinson | Optometry | 1655 S Hwy 65 82, Lake Village, AR 71653-1661 | |
| James C Wright | Family Medicine | Lake Village Clinic Pa | 2918 Louis Session St, Lake Village, AR 71653-6049 |
| Jo Anne Gregory | Family Medicine | Lake Village Clinic Pa | 2918 Louis Session St, Lake Village, AR 71653-6049 |
| Christopher M Johnson | Nurse Practitioner | Lake Village Clinic Pa | 2918 Louis Session St, Lake Village, AR 71653-6049 |
| John P Burge | General Surgery | Lake Village Clinic Pa | 2918 Louis Session St, Lake Village, AR 71653-6049 |
| John R Russell | Family Medicine | 2918 Louis Session St, Lake Village, AR 71653-6049 | |
| Mohanned H Ahmed | Family Medicine | Arkansas Emergency Staffing Solutions Inc | 2729 S Hwy 65 and 82, Lake Village, AR 71653-6136 |
| Justin G Gates | Certified Registered Nurse Anesthetist (crna) | Chicot Memorial Medical Center | 2729 Hwy 65 and 82 S, Chicot Memorial Anesthesia Services, Lake Village, AR 71653-6136 |
| Ben P Folk Iii | Cardiovascular Disease (cardiology) | 2729s Hwy 65 82, Lake Village, AR 71653-6136 | |
| Find all physicians in zip 71653 | |||
| City | LAKE VILLAGE |
| Zip Code | 71653 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LAKE VILLAGE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Autumn M Bennett.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.