Bennett, Amanda Blanche

Bennett, Amanda Blanche is an individual health care provider with primary practice located at 8004 Myrtle Trace Dr Ste 200 , Conway SC 29526-8945. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Bennett, Amanda Blanche can be contacted via phone (843) 347-8041.

Contact Information

Primary practice address
8004 Myrtle Trace Dr Ste 200 Conway SC 29526-8945
Phone: (843) 347-8041
Fax: (843) 347-8042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 5901 South Carolina

Profile Details

NPI number 1376908657
LBN Legal business name Bennett, Amanda Blanche
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2015
Last updated Sep 4th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376908657 NPPES
South Carolina MEDICAID 8123PA

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