| Leta Marie Bennison, CNP | |
|
415 N 26th St Ste 202, Lafayette, IN 47904-2856 | |
| (765) 448-8639 | |
| (765) 448-8156 |
| Full Name | Leta Marie Bennison |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 415 N 26th St Ste 202, Lafayette, Indiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649344227 | NPI | - | NPPES |
| 000000582659 | Other | IN | ANTHEM PROVIDER NUMBER |
| 200911130 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71002721A (Indiana) | Primary |
| 363L00000X | Nurse Practitioner | 4704155800 (Michigan) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Leta Marie Bennison, CNP Po Box 5545, Lafayette, IN 47903-5545 Ph: (765) 448-8000 | Leta Marie Bennison, CNP 415 N 26th St Ste 202, Lafayette, IN 47904-2856 Ph: (765) 448-8639 |
Abigail Ann Crum, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 | |
Kimbra Weesner, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1508 Tippecanoe St, Lafayette, IN 47904 Phone: 765-423-6400 | |
Mrs. Cecilia Ann Winkler, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5500 State Road 38 E, Lafayette, IN 47905 Phone: 765-449-6790 Fax: 765-772-7113 | |
Harmony Stine, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1345 Unity Pl Ste 355, Lafayette, IN 47905 Phone: 765-807-7988 Fax: 765-807-7989 | |
Monica Michele Roadruck, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3218 Daugherty Dr Ste 140, Lafayette, IN 47909 Phone: 765-502-4190 Fax: 765-502-4191 | |
Julie J Debord, AGNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 | |
Venice Michele Jarrett, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2600 Ferry St, Lafayette, IN 47904 Phone: 765-448-8100 |