Individual
MRS. CARRIE HEATHER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2476 CANTON RD, MARIETTA, GA 30066-5377
(770) 951-1565
(770) 573-9513
Mailing address
2476 CANTON RD, MARIETTA, GA 30066-5377
(770) 951-1565
(770) 573-9513
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-073471
AL
363L00000X
Nurse Practitioner
Primary
28240019A
IN
363L00000X
Nurse Practitioner
RN237110
GA
Other
Enumeration date
10/01/2007
Last updated
03/11/2019
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