Provider Demographics
NPI:1083891725
Name:BENNETT, SHARON M (DNP, APRN, BC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DNP, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 SAINT SEBASTIAN WAY
Mailing Address - Street 2:EC 1500
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-4210
Mailing Address - Country:US
Mailing Address - Phone:706-721-1195
Mailing Address - Fax:706-721-1199
Practice Address - Street 1:987 SAINT SEBASTIAN WAY
Practice Address - Street 2:EC 1500
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-4210
Practice Address - Country:US
Practice Address - Phone:706-721-1195
Practice Address - Fax:706-721-1199
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN042056163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health