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

Jacqueline Corinne Gibson, CMA-CPT-GANOTARY

Individual provider Phlebotomy Technician · NPI 1770273112

Jacqueline Corinne Gibson, CMA-CPT-GANOTARY is a Phlebotomy Technician in Grovetown, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2023
Specialties on file
3

Practice location Address checks out

6106 Independence Way
Grovetown, GA 30813-1206
Phone: (706) 284-2077
Show map & directions

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

Specialties & licences

Phlebotomy Technician (primary) Taxonomy 246RP1900X · Licence GA-11412-75795 (GA)
Phlebotomy Technician Taxonomy 246RP1900X · Licence N23101917 (GA)
Community Health Worker Taxonomy 172V00000X (GA)

Record details

NPI number1770273112
Entity typeIndividual (Type 1)
GenderFemale
Credentials CMA-CPT-GANOTARY
Sole proprietorYes
NPI enumeratedMay 9, 2023
Last updated in NPPESJanuary 5, 2026
Certification dateJanuary 5, 2026

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