Provider Demographics
NPI:1164776126
Name:HAYNES, ASHLEY O'BARR (CPNP-AC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:O'BARR
Last Name:HAYNES
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5705 UPTAIN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5613
Mailing Address - Country:US
Mailing Address - Phone:423-266-6918
Mailing Address - Fax:423-265-0620
Practice Address - Street 1:5705 UPTAIN RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5613
Practice Address - Country:US
Practice Address - Phone:423-266-6918
Practice Address - Fax:423-265-0620
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN17068363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics