Individual
MS. TINA RENEE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
570 E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 540-2317
Mailing address
536 SPRINGHILL XING, BRANDON, MS 39047-5019
(601) 540-2317
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906542
MS
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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