Individual
BRANDI NICOLE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
215 MEDICAL PARK DR, ANDALUSIA, AL 36420-5354
(334) 222-4327
Mailing address
19588 ENOCH RD, ANDALUSIA, AL 36421-6108
(334) 343-0014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-140569
AL
Other
Enumeration date
06/28/2020
Last updated
12/07/2023
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