Jennifer S Bennett, NP-C
Individual provider Active NPI Nurse Practitioner · Toccoa, GA
NPI 1801101035 · NPPES record last updated Aug 12, 2010
Key facts
- NPI
- 1801101035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 144863 (GA)
- Practice address
- 58 Big a Road
Toccoa, GA 30577-6000 - Phone
- (706) 886-6819
- Fax
- (706) 282-5368
- NPI assigned
- Aug 12, 2010
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 144863 | GA | Yes |
Addresses
Primary practice location
58 Big a Road
Toccoa, GA 30577-6000
Mailing address
58 Big a Road
Toccoa, GA 30577-6000
Phone (706) 886-6819
Other providers in Toccoa, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2010. 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.