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Individual

MARKETTA HAYNES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
128 BEDFORD WHITE RD, JACKSON, TN 38305-5930
(731) 217-7884
Mailing address
128 BEDFORD WHITE RD, JACKSON, TN 38305-5930
(731) 217-7884

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
3747P1801X
Personal Care Attendant
376K00000X
Nurse's Aide
00221558
TN

Other

Enumeration date
05/15/2025
Last updated
02/04/2026
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