Bennett, Sally D

Bennett, Sally D is an sole proprietor health care provider with primary practice located at 130 N Gross Rd Ste 201, Kingsland GA 31548. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bennett, Sally D can be contacted via phone (912) 729-2795.

Contact Information

Primary practice address
130 N Gross Rd Ste 201 Kingsland GA 31548
Phone: (912) 729-2795
Fax: (912) 729-4117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN094886 Georgia

Profile Details

NPI number 1336181536
LBN Legal business name Bennett, Sally D
Credentials APRN BC FNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2006
Last updated Aug 16th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336181536 NPPES
Georgia Other 5000021728 RR MC
Georgia MEDICAID 00830244C RR MC
Georgia MEDICAID 00830244D RR MC

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