Jackquelyn Countee
Individual provider Active NPI Driver · Valdosta, GA
NPI 1104544162 · NPPES record last updated Aug 16, 2022
Key facts
- NPI
- 1104544162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 805 Lausanne Dr
Valdosta, GA 31601-4152 - Phone
- (678) 245-9472
- NPI assigned
- Aug 16, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
805 Lausanne Dr
Valdosta, GA 31601-4152
Mailing address
805 Lausanne Dr
Valdosta, GA 31601-4152
Phone (678) 245-9472
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jctransportationservice@gmail.com |
Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.