NPI 1104364173 · live from the CMS NPI Registry
Sara Ruth Bennett, FNP-BC
Nurse Practitioner, Family in Atlanta, GA. National Provider Identifier 1104364173, active.
NPI record
| NPI | 1104364173 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 865 N Highland Ave Ne, Atlanta, GA 30306 |
| Practice phone | 404-733-6089 |
| Mailing address | 1975 Highway 54 W Ste 255, Peachtree City, GA 30269 |
| Enumerated | February 9, 2017 |
| Last updated | March 23, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | RN165031 (GA) |
| Nurse Practitioner, Family primary | 363LF0000X | RN165031 (GA) |
| Registered Nurse, General Practice | 163WG0000X | RN165031 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.