Shanon Dione Bennett, PA-C

Physician Assistant · Waterloo, IA

Individual Active NPI

NPI number 1013979079

Practice location

1731 W Ridgeway Ave Ste 100
Waterloo, IA 50701-4591
Phone
(319) 833-5888
Fax
(319) 833-5891

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NPI record

NPI
1013979079
Entity type
Individual (Type 1)
Enumeration date
April 5, 2006
Last updated
July 21, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 001016 IA
Medical Physician Assistant 363AM0700X 001000136 NC

About Shanon Bennett

Shanon Dione Bennett, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1731 W Ridgeway Ave Ste 100, Waterloo, IA 50701-4591. The NPI number 1013979079 was assigned on April 5, 2006 and the record was last updated on July 21, 2022.

Shanon Bennett lists 2 licenses in the registry: #001016 (IA) for Physician Assistant; #001000136 (NC) for Medical Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shanon Dione Bennett, PA-C?

The NPI number is 1013979079.

What is the phone number of Shanon Bennett?

The phone number listed for the practice location is (319) 833-5888.

Where is Shanon Bennett located?

1731 W Ridgeway Ave Ste 100, Waterloo, IA 50701-4591.

What is the taxonomy code for Shanon Bennett?

The primary taxonomy code is 363A00000X – Physician Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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