| Doctor Name: | CARLA SUE BENNETT |
| NPI Number: | 1073829461 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 4704212215 |
| Business Practice Address: | 2076 Hwy 42 W Suite 300 Clayton, NC - 275209226 |
| Business Phone Number: | 9199387113 |
| Business Fax Number: | |
| Mailing Address: | 2076 Hwy 42 W, Suite 300 CLAYTON |
| State: | NC |
| Postal Code: | 275209226 |
| Phone Number: | 9199387113 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2010 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704212215 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |