Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Autumn Lee Bennett

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1891461729

Autumn Lee Bennett is a Student in an Organized Health Care Education/Training Program in Bloomington, Indiana. Works from 2 locations. Licensed in Indiana and Michigan.

Licensed in
IN, MI
In the registry since
2021
Specialties on file
2

Practice location Address checks out

1001 E 17th St
Bloomington, IN 47408-1590
Phone: (517) 331-4654
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3521 Breezy Point Dr, Okemos, MI 48864-5967 — (517) 331-4654

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 36003760A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (MI)

Record details

NPI number1891461729
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 19, 2021
Last updated in NPPESJuly 7, 2023
Certification dateJuly 7, 2023
Mailing address3521 Breezy Point Dr, Okemos, MI 48864-5967

Other providers in Bloomington