Provider Demographics
NPI:1205258456
Name:FLYNN, HAYLEE ELISE (AGACNP, RN-BSN)
Entity type:Individual
Prefix:MRS
First Name:HAYLEE
Middle Name:ELISE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:AGACNP, RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 SEINER CT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2627
Mailing Address - Country:US
Mailing Address - Phone:865-310-7770
Mailing Address - Fax:
Practice Address - Street 1:300 STONECREST BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5688
Practice Address - Country:US
Practice Address - Phone:865-310-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18436363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN18436OtherSTATE LICENSE
2013019651OtherANCC