Individual
MRS. KIMBERLY DAVIS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1104 THELMA HWY, HOMERVILLE, GA 31634-3548
(229) 588-1185
Mailing address
1104 THELMA HWY, HOMERVILLE, GA 31634-3548
(229) 588-1185
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN202112
GA
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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