Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqueline Bennett, CEO

Individual provider Medical Laboratory Technician · NPI 1992597496

Jacqueline Bennett, CEO is a Medical Laboratory Technician in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2025.

Licensed in
GA
In the registry since
2025

Practice location Address checks out

1139 Hwy 54 E Lanier Ave Ste J
Fayetteville, GA 30215
Phone: (470) 302-7769
Fax: (888) 666-1770
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Laboratory Technician (primary) Taxonomy 246RM2200X · Licence 9435480646JB (GA)

Record details

NPI number1992597496
Entity typeIndividual (Type 1)
GenderFemale
Credentials CEO
Sole proprietorNo
NPI enumeratedMay 20, 2025
Last updated in NPPESMay 20, 2025
Certification dateMay 11, 2025
Mailing address1545 N Expressway Unit 137, Griffin, GA 30223-1746

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