Individual
AUDREY PHILLIPS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
10175 LITTLE PATUXENT PKWY, COLUMBIA, MD 21044-2655
(251) 604-4785
Mailing address
224 LIGHTHOUSE DR, DOTHAN, AL 36305-7302
(334) 798-1555
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A0310068
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A0310068
CERTIFIED NURSE PRACTITIONER NUMBER
AL
Enumeration date
04/08/2010
Last updated
08/26/2024
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