Provider Demographics
NPI:1699708529
Name:BENTLEY, ANNE M (ARNP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 GOODLETTE RD N
Mailing Address - Street 2:STE 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5406
Mailing Address - Country:US
Mailing Address - Phone:239-262-8226
Mailing Address - Fax:
Practice Address - Street 1:1008 GOODLETTE RD N
Practice Address - Street 2:STE 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5406
Practice Address - Country:US
Practice Address - Phone:239-262-8226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1967752363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY063HOtherBLUE SHIELD
FL40916COtherBLUE CROSS
FLP27506Medicare UPIN