Individual
MS. AMANDA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2000 RIVERSIDE PKWY STE 207, LAWRENCEVILLE, GA 30043-5926
(678) 646-0404
(678) 646-0202
Mailing address
2000 RIVERSIDE PKWY STE 207, LAWRENCEVILLE, GA 30043-5926
(678) 646-0404
(678) 646-0202
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN216022
GA
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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