Canstrell Darrisaw Hines
Individual provider Active NPI Clinical Medical Laboratory · Wrightsville, GA
NPI 1346046513 · NPPES record last updated Feb 19, 2025
Key facts
- NPI
- 1346046513
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Practice address
- 59 Hines Rd
Wrightsville, GA 31096-4151 - Phone
- (478) 278-3613
- NPI assigned
- Feb 19, 2025
- 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 |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
59 Hines Rd
Wrightsville, GA 31096-4151
Mailing address
59 Hines Rd
Wrightsville, GA 31096-4151
Phone (478) 278-3613
Other providers in Wrightsville, GA
- Penny Campbell Foskey
- Kim Greenway
- Melissa Murray Hansen
- Shirley Dianne Harrison
- Sarah Helton
- Hospice Advantage, LLC.
- Anthony Lewis Howard Sr.
- Christy Clyborne Jackson
- Johnson County Board of Health
- Johnson County Center for Community Health
All providers in Wrightsville, GA · Clinical Medical Laboratory in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2025. 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.