Provider Demographics
NPI:1952980005
Name:HAYNES, ELLIOTT JOSEPH (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:JOSEPH
Last Name:HAYNES
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 DIXIE LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-7946
Mailing Address - Country:US
Mailing Address - Phone:615-480-5132
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST STE 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2385
Practice Address - Country:US
Practice Address - Phone:615-342-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29294363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily