Individual
LASHON RENEE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERD NURSE
Contact information
Practice address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-7893
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-7893
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN124219
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606317B
—
GA
Enumeration date
05/16/2011
Last updated
05/16/2011
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