Individual
JENNIFER DEHAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2141 OLD ASHLAND CITY RD, CLARKSVILLE, TN 37043-4906
(931) 919-3361
(931) 919-3362
Mailing address
2141 OLD ASHLAND CITY RD, CLARKSVILLE, TN 37043-4906
(931) 919-3361
(931) 919-3362
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN0000012616
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33410931
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
—
Enumeration date
03/27/2007
Last updated
03/29/2017
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