Individual
CAROL C HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FND MSN
Contact information
Practice address
100 HERNDON DR, BELLS, TN 38006-3659
(731) 661-0086
Mailing address
100 HERNDON DR, BELLS, TN 38006-3659
(731) 661-0086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN 33950
TN
363L00000X
Nurse Practitioner
Primary
APN0000005156
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I500676
MEDICARE PTAN
TN
05
—
3341627
—
TN
Enumeration date
10/07/2005
Last updated
03/07/2023
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