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Individual

MS. TAMMY BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
1757 WOODRUFF RD, GREENVILLE, SC 29607-6943
(864) 458-9288
(864) 458-9289
Mailing address
1757 WOODRUFF RD, GREENVILLE, SC 29607-6943
(864) 458-9288
(864) 458-9289

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3073
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP1077
SC
Enumeration date
10/24/2006
Last updated
02/16/2016
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