Shanon Dione Bennett, PA-C

NPI #1013979079 in Waterloo, Iowa

Provider Information

NPI Number: 1013979079
Entity Type: Individual
Name: Shanon Dione Bennett, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 5, 2006
Last Updated: Jul 21, 2022

Practice Location

Address: 1731 W RIDGEWAY AVE STE 100
City: Waterloo
State: Iowa
ZIP Code: 50701-4591
Phone: (319) 833-5888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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