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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Jillian Frances Bensen-Eder
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All providers in Richmond Hill, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.