Individual
ALISHA SALO BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10055 FORD AVE STE 5A, RICHMOND HILL, GA 31324-3974
(912) 414-6563
Mailing address
10055 FORD AVE STE 5A, RICHMOND HILL, GA 31324-3974
(912) 414-6563
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN202172
GA
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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