Individual
NANCY LOUISE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
712 E PEACE ST, CANTON, MS 39046-4731
(601) 720-1531
Mailing address
328 E OTTO ST, CANTON, MS 39046-4324
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
903080
MS
Other
Enumeration date
12/20/2018
Last updated
09/04/2024
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