Individual
MRS. AMANDA ELIZABETH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
102 SOUTH THRID STREET, SUITE 100, CARSON CITY, MI 48811
(989) 584-1308
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 253-6320
(517) 364-6208
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704282874
MI
Other
Enumeration date
08/15/2017
Last updated
02/08/2018
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