IndividualActive
Jacqueline Bennett, C.E.O
NPI 1992597496 · Medical Laboratory Technician · Fayetteville, GA
Provider details
- NPI number
- 1992597496
- Entity type
- Individual
- Primary specialty
- Medical Laboratory TechnicianTechnologists, Technicians & Other Technical Service Providers
- Credential
- C.E.O
- Sex
- Female
- Sole proprietor
- No
- License
- 9435480646JB (GA)
Practice location
1139 Hwy 54 E Lanier Ave Suite J
Fayetteville, GA 30215
Phone: (470) 302-7769
Fax: (888) 666-1770
Mailing address
1545 N Expressway Unit 137
Griffin, GA 30223-1746
Registry dates
- Enumerated
- 2025-05-20
- Last updated
- 2025-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.