Bennett, Tara Alea

Bennett, Tara Alea is an individual health care provider with primary practice located at 500 Lakeshore Pkwy , Rock Hill SC 29730-4273. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bennett, Tara Alea can be contacted via phone (803) 818-6955.

Contact Information

Primary practice address
500 Lakeshore Pkwy Rock Hill SC 29730-4273
Phone: (803) 818-6955
Fax: (803) 818-6993
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 18300 South Carolina

Profile Details

NPI number 1992137368
LBN Legal business name Bennett, Tara Alea
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2013
Last updated Aug 23rd, 2021 - about 5 years ago

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 1992137368 NPPES
South Carolina MEDICAID NP2628

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