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NPI Profile for JACQUELINE BENNETT in FAYETTEVILLE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Laboratory |
246RM2200X |
| NPI # | 1992597496 |
|
| Status | Active | |
| Credentials | C.E.O | |
| Entity | Individual | |
| Enumeration date | 05/20/2025 | |
| Last updated | 05/20/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JACQUELINE BENNETT, C.E.O