Individual
LAINE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12 ARBORLAND WAY, GREENVILLE, SC 29615-2201
(864) 297-6010
(864) 458-7673
Mailing address
12 ARBORLAND WAY, GREENVILLE, SC 29615-2201
(864) 297-6010
(864) 458-7673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN2270
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA87265193
MEDICARE PIN
SC
05
—
NPO753
—
SC
Enumeration date
07/12/2006
Last updated
11/24/2020
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