Individual
ELIZABETH ANNE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1014 HIGHWAY 51, MADISON, MS 39110-8304
(601) 856-2021
Mailing address
1014 HIGHWAY 51, MADISON, MS 39110-8304
(601) 856-2021
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-12617
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-12617
MISSISSIPPI BOARD OF PHARMACY
MS
Enumeration date
06/10/2014
Last updated
12/24/2020
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