Individual
STACI THOMAS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
800 1ST ST STE 410, MACON, GA 31201-8306
(478) 743-7068
(478) 743-4297
Mailing address
800 1ST ST STE 410, MACON, GA 31201-8306
(478) 320-4644
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN-NP193050
GA
Other
Enumeration date
04/16/2020
Last updated
10/15/2025
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