Millicent Caroline Bennett
Individual provider Active NPI Nurse Practitioner · Spring Hill, TN
NPI 1134826787 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1134826787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 33475 (TN)
- Practice address
- 5421 Main St
Spring Hill, TN 37174-4410 - Phone
- (931) 486-2500
- NPI assigned
- Feb 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230328001442 | TN | Order and Referring Only - Nurse Practitioner | 8325412679 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 235764 | TN | MD | Registered Nurse |
| 33475 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maury Regional Hospital Marshall Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 235764 | TN | |
| Nurse Practitioner | 363L00000X | 33475 | TN | Yes |
Addresses
Primary practice location
5421 Main St
Spring Hill, TN 37174-4410
Mailing address
5421 Main St
Spring Hill, TN 37174-4410
Other providers in Spring Hill, TN
- William Blair Baxter
- Christopher Alan Beavers
- Toren D Bell
- Kylie Beller
- Julian A Bennett
- Hannah Bennington
- Melanie B Berg
- Jeryl L Berger
- Aaliyah Rae Berry
- Katrina Denece Berry
All providers in Spring Hill, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.