Individual
DESSIRAE MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3333 WRIGHTSVILLE AVE STE M, WILMINGTON, NC 28403-4115
(910) 399-3519
(910) 769-1739
Mailing address
3333 WRIGHTSVILLE AVE STE M, WILMINGTON, NC 28403-4115
(910) 399-3519
(910) 769-1739
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
321110
NC
363LA2200X
Adult Health Nurse Practitioner
321110
NC
363LG0600X
Gerontology Nurse Practitioner
321110
NC
363LP2300X
Primary Care Nurse Practitioner
321110
NC
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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