Individual
ASHLEY BENITEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 ALABAMA AVE S, BREMEN, GA 30110-2501
(678) 821-6400
(678) 821-6401
Mailing address
249 VALLEY DR, BREMEN, GA 30110-5435
(256) 525-0834
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN278135
GA
363LF0000X
Family Nurse Practitioner
1-175802
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861915647
GROUP NPI
GA
01
—
RN278135
LICENSE
GA
Enumeration date
01/12/2022
Last updated
03/20/2025
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