Nicole Andrea Bennett, PMHNP-BC is a
Nurse Practitioner - Psychiatric/mental Health based in East Alton, Illinois. Nicole Andrea Bennett is licensed to practice in Illinois (license number 209030085) and her current practice location is
2 Terminal Dr Ste 8, East Alton, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 259-0365.
NPI number for Nicole Andrea Bennett is 1679163372 and her current mailing address is 2 Terminal Dr Ste 8, East Alton, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1679163372.
Provider's Profile
Full Name | Nicole Andrea Bennett |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 2 Terminal Dr Ste 8, East Alton, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1679163372
- Provider Enumeration Date: 01/26/2021
- Last Update Date: 08/07/2024
Medical Identifiers
Medical identifiers for Nicole Andrea Bennett such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679163372 | NPI | - | NPPES |
041470020 | Other | IL | RN |
2018036588 | Other | MO | RN |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163WP0808X | Registered Nurse - Psychiatric/mental Health | 2018036588 (Missouri) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209030085 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Andrea Bennett is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nicole Andrea Bennett, PMHNP-BC 2 Terminal Dr Ste 8, East Alton, IL 62024-2294 Ph: (618) 259-0365 | Nicole Andrea Bennett, PMHNP-BC 2 Terminal Dr Ste 8, East Alton, IL 62024-2294 Ph: (618) 259-0365 |
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