Ebony Logan Wilson, PHLEBOTOMIST, INS
Individual provider Active NPI Phlebotomy Technician · Smith Station, AL
NPI 1851285654 · NPPES record last updated Jun 5, 2025
Key facts
- NPI
- 1851285654
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Phlebotomy Technician 246RP1900X
- License
- NAPTP5057396062 (GA)
- Practice address
- 223 Paradise Drive
Smith Station, AL 36877 - Phone
- (334) 219-0308
- NPI assigned
- Jun 5, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NAPTP5057396062 | GA | MD | Phlebotomy Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | NAPTP5057396062 | GA | Yes |
Addresses
Primary practice location
223 Paradise Drive
Smith Station, AL 36877
Mailing address
3515 Summerville Rd
Phenix City, AL 36867-2628
Phone (334) 614-2132
Other names
- Ebony Logan Wilson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 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.