Madison Bennett

Individual provider Active NPI Critical Care Medicine Registered Nurse · Gray, GA

NPI 1487486809 · NPPES record last updated Aug 14, 2024

Key facts

NPI
1487486809
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine Registered Nurse 163WC0200X
License
RN323341 (GA)
Practice address
131 Sand Creek TRL
Gray, GA 31032-4801
Phone
(478) 234-4180
NPI assigned
Aug 14, 2024
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)
No

State licenses

LicenseStateTypeSpecialty
RN323341GAMDCritical Care Medicine Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN323341 GA Yes

Addresses

Primary practice location

131 Sand Creek TRL
Gray, GA 31032-4801

Mailing address

131 Sand Creek TRL
Gray, GA 31032-4801

Other providers in Gray, GA

All providers in Gray, GA · Critical Care Medicine Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.