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General NPI Number Information
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NPI Number | 1548123060
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Entity Type | Individual
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Provider Name | JACQUELINE HINES CANNADY LAB OWNER
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 151 MCCORMICK RD
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City | SANFORD
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State | NC
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Zip | 27332
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Country | US
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Telephone | 919-592-7374
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Fax |
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Provider Business Mailing Address
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Address Line | 151 MC CORMICK ROAD
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City | SANFORD
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State | NC
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Zip | 27332
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Country | US
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Telephone | 919-592-7374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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