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Individual
MRS. SALLY D BENNETT
Active
Individual
MRS. SALLY D BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN BC FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN094886
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00830244C
—
GA
05
—
00830244D
—
GA
01
—
5000021728
RR MC
GA
Enumeration date
06/12/2006
Last updated
08/16/2022
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