| Ebonique T Bennett, NP | |
|
10 Saint Patricks Dr, Waldorf, MD 20603-4527 | |
| (301) 373-7900 | |
| (301) 373-6900 |
| Full Name | Ebonique T Bennett |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 14 Years |
| Location | 10 Saint Patricks Dr, Waldorf, Maryland |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972871523 | NPI | - | NPPES |
| 840027000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 305905 (New York) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medstar Medical Group - Southern Maryland Llc | 1355667056 | 224 |
| Medstar Medical Group - Southern Maryland Llc | 1355667056 | 224 |
| Entity Name | Medstar Medical Group - Southern Maryland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831592211 PECOS PAC ID: 1355667056 Enrollment ID: O20150223001281 |
| Mailing Address | Practice Location Address |
|---|---|
| Ebonique T Bennett, NP 10 Saint Patricks Dr, Waldorf, MD 20603-4527 Ph: (301) 373-7900 | Ebonique T Bennett, NP 10 Saint Patricks Dr, Waldorf, MD 20603-4527 Ph: (301) 373-7900 |
Mr. Moenil Patel, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10 Saint Patricks Dr, Waldorf, MD 20603 Phone: 301-373-7900 Fax: 301-373-6900 | |
Ms. Gloria Alice Johnston, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 50 Post Office Rd Ste 302, Waldorf, MD 20602 Phone: 240-353-2516 Fax: 240-448-8893 | |
Vanessa Wansel, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2193 Everett Ct, Waldorf, MD 20601 Phone: 301-535-8457 | |
Emily Rosa Odenwald, MSN, WHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 173 Saint Patricks Dr Ste 104, Waldorf, MD 20603 Phone: 888-731-8994 | |
Ayanna Riley, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11610 Lewisham Pl Apt 305, Waldorf, MD 20602 Phone: 201-667-8892 | |
Dawnette Gaylene Campbell, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10542 Black Pine Ln, Waldorf, MD 20603 Phone: 301-537-3642 | |
Queen K Iji, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3070 Crain Hwy, Waldorf, MD 20601 Phone: 301-645-3556 |