Individual
ASHLYNN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 425-4860
(601) 425-4993
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R894317
MS
Other
Enumeration date
09/10/2015
Last updated
05/28/2020
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