Provider Demographics
NPI:1164650420
Name:BENNETT, KAREN WEBB (PHD, RD, MSN, PMHNP)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:WEBB
Last Name:BENNETT
Suffix:
Gender:F
Credentials:PHD, RD, MSN, PMHNP
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Mailing Address - Street 1:110 W WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-6760
Mailing Address - Country:US
Mailing Address - Phone:336-633-7000
Mailing Address - Fax:336-625-3817
Practice Address - Street 1:5306 NC HIGHWAY 55 STE 105
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7812
Practice Address - Country:US
Practice Address - Phone:919-457-1517
Practice Address - Fax:919-363-7697
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC191449363LP0808X
OR200950062NP363LP0808X
AK1323363LP0808X
NC5005937363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health