Provider Demographics
NPI:1912610346
Name:BENNETT, MARYIN CHRISTINA
Entity type:Individual
Prefix:MS
First Name:MARYIN
Middle Name:CHRISTINA
Last Name:BENNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8961 DALY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4634
Mailing Address - Country:US
Mailing Address - Phone:513-254-2975
Mailing Address - Fax:
Practice Address - Street 1:8961 DALY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4634
Practice Address - Country:US
Practice Address - Phone:513-254-2975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide