Alisha Salo Bennett, FNP

Individual provider Active NPI Family Nurse Practitioner · Richmond Hill, GA

NPI 1184024697 · NPPES record last updated Sep 3, 2014

Key facts

NPI
1184024697
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN202172 (GA)
Practice address
10055 Ford Ave Ste 5a
Richmond Hill, GA 31324-3974
Phone
(912) 414-6563
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN202172 GA Yes

Addresses

Primary practice location

10055 Ford Ave Ste 5a
Richmond Hill, GA 31324-3974

Mailing address

10055 Ford Ave Ste 5a
Richmond Hill, GA 31324-3974
Phone (912) 414-6563

Other providers in Richmond Hill, GA

All providers in Richmond Hill, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.