Most Relevant Information
Provider Data
| NPI Number: | 1003324484 |
| Provider Name: | NICOLE BENNETT |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/18/2018 |
| Last Updated: | 01/18/2018 |
Provider Practice Location
4773 CAUGHLIN PKWY STE 2
RENO
NV
895191012
Practice Location Phone/Fax
| Phone: | 7756772216 |
| Fax: |
Provider Mailing Location
4773 CAUGHLIN PKWY STE 2
RENO
NV
895191012
Provider Mailing Phone/Fax
| Phone: | 7756772216 |
| Fax: |