JACQUELINE CORINNE GIBSON CMA-CPT-GANOTARY
NPI 1770273112
Technician, Pathology - Phlebotomy in Grovetown, GA
Active since May 09, 2023
About Jacqueline Corinne Gibson Cma-cpt-ganotary NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE CORINNE GIBSON CMA-CPT-GANOTARY (NPI 1770273112) is an individual phlebotomy provider in Grovetown, Georgia, licensed in Georgia (GA-11412-75795) and active in the NPI registry since May 2023.
NPPES Registry Identity
NPI1770273112
Entity TypeIndividualFemale
Primary Taxonomy246RP1900X
Provider Legal NameJACQUELINE CORINNE GIBSONCredential: CMA-CPT-GANOTARY
Location Address6106 INDEPENDENCE WAYGrovetown, GA 30813-1206
Mailing Address6106 Independence WayGrovetown, GA 30813-1206 · (706) 284-2077
Phone(706) 284-2077
Sole ProprietorYes
Enumeration DateMay 9, 2023
Last NPPES UpdateJanuary 5, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2026
✔ NPI 1770273112 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyTechnician, Pathology · PhlebotomyTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246RP1900X
Licenses✔ Licensed in GA · GA-11412-75795✔ Licensed in GA · N23101917
Also ListedCommunity Health WorkerTaxonomy 172V00000X
6106 INDEPENDENCE WAY, Grovetown, GA 30813
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770273112, enumerated as an "individual" on May 09, 2023.
The provider is located at 6106 INDEPENDENCE WAY GROVETOWN, GA 30813 and the phone number is (706) 284-2077.
Technician, Pathology with taxonomy code 246RP1900X and a focus in Phlebotomy.
