Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 24308 | SC |
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.024580 | OH |
NPI | 1023676681 |
---|---|
Provider Name | Ms. Janet Bennett |
First Address | Charlotte, NC 28260-3898 |
Second Address | Florence, SC 29505-6047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2019 |
Last Update Date | 19/04/2021 |