Mrs Tara Alea Bennett, FNP | |
500 Lakeshore Pkwy, Rock Hill, SC 29730-4273 | |
(803) 818-6955 | |
(803) 818-6993 |
Full Name | Mrs Tara Alea Bennett |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 500 Lakeshore Pkwy, Rock Hill, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992137368 | NPI | - | NPPES |
NP2628 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 18300 (South Carolina) | Primary |
Entity Name | Providence House Calls Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689912495 PECOS PAC ID: 1759528250 Enrollment ID: O20130430000366 |
Mailing Address | Practice Location Address |
---|---|
Mrs Tara Alea Bennett, FNP 500 Lakeshore Pkwy, Rock Hill, SC 29730-4273 Ph: (803) 818-6955 | Mrs Tara Alea Bennett, FNP 500 Lakeshore Pkwy, Rock Hill, SC 29730-4273 Ph: (803) 818-6955 |
Mrs. Mary Jo Barreto, APRN-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Winthrop University Health Services, Rock Hill, SC 29733 Phone: 803-323-2206 Fax: 803-323-3332 | |
Miss Kristene C Diggins, FNP, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 500 Lakeshore Pkwy, Rock Hill, SC 29730 Phone: 704-441-7675 | |
Ms. Wanda Kaye Clark, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1151 Camden Ave, Rock Hill, SC 29732 Phone: 803-909-6363 Fax: 803-909-6364 | |
Marta Pacheco, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1617 Shetland Ln, Rock Hill, SC 29730 Phone: 540-797-4361 | |
Andrea Blakeman, APRN Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 1131 Saluda St, Rock Hill, SC 29730 Phone: 803-325-7744 Fax: 803-325-1117 | |
Sarah Elizabeth Christ, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 170 Amendment Ave, Rock Hill, SC 29732 Phone: 803-324-7607 Fax: 800-332-4409 | |
Mr. Gerald Alfred Bracete, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 Lakeshore Pkwy, Rock Hill, SC 29730 Phone: 803-909-6363 |