Individual
ALYSSA JOY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
136 FORREST DR, FOUNTAIN INN, SC 29644-1735
(864) 770-5086
Mailing address
136 FORREST DR, FOUNTAIN INN, SC 29644-1735
(864) 770-5086
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
249994
SC
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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