Provider Demographics
NPI:1356778112
Name:DENTON-BENNETT, JANET M (CNM)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:DENTON-BENNETT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4826 CLARKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-3326
Mailing Address - Country:US
Mailing Address - Phone:470-577-0718
Mailing Address - Fax:
Practice Address - Street 1:1942 ATKINSON RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5003
Practice Address - Country:US
Practice Address - Phone:470-577-0718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIAP9766176B00000X
GARN248759367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife