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CAROL A BENNETT ARNP
>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1093813370
Individual Registrant: CAROL A BENNETT ARNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1302 RIVER ST PALATKA, FL 32177-5042 US
Tel: 386-328-8371 Fax: 386-328-1519
Tel: 386-328-8371 Fax: 386-328-1519
Contact information for business:
1302 RIVER ST PALATKA, FL 32177-5042 US
Tel: 386-328-8371 Fax: 386-328-1519
Tel: 386-328-8371 Fax: 386-328-1519
Registration Information:
NPI: 1093813370
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | FL | ARNP1550822 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 308868500 | FL | 05 | |
| BCBS PROVIDER # | Y0568 | FL | 01 |
