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MICHELLE SIMONE BENNETT
>> Nurse's Aide >> Nursing Service Related ProvidersRegistrant NPI Number: 1194988006
Individual Registrant: MICHELLE SIMONE BENNETT
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
6697 PINE VALLEY TRCE STONE MOUNTAIN, GA 30087-5819 US
Tel: 770-498-5538 Fax: --
Tel: 770-498-5538 Fax: --
Contact information for business:
6697 PINE VALLEY TRCE STONE MOUNTAIN, GA 30087-5819 US
Tel: 770-498-5538 Fax: --
Tel: 770-498-5538 Fax: --
Registration Information:
NPI: 1194988006
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 376K00000X | Nursing Service Related Providers Nurse's Aide | GA | CN0028882430 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
