Jacqueline Alisia Violet Bennett, RN Valid NPI

Individual provider · Registered Nurse · Gallup, NM

NPI

1619830619

Type

Individual (Type 1)

Primary specialty

Registered Nurse

Specialty group

Nursing Service Providers

Taxonomy code

163W00000X

License number

64532 (NM)

Sex

Female

Sole proprietor

No

Enumerated

2025-12-05

Last updated

2025-12-05