Jennifer Dehaven, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN0000012616 Issued in TN

Practice address

2141 Old Ashland City Rd
Clarksville, TN 37043-4906

Phone

(931) 919-3361

Fax

(931) 919-3362

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1235257106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 OLD ASHLAND CITY RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434906",
            "telephone_number": "931-919-3361",
            "fax_number": "931-919-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 OLD ASHLAND CITY RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434906",
            "telephone_number": "931-919-3361",
            "fax_number": "931-919-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "JENNIFER",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN0000012616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER (PTAN)",
            "identifier": "33410931",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Marie Deeds, DMD
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• Brittany Degner, M.S., BCBA, LBA
• Jill Degraauw, FNP
• Breanna Leigh Dekuiper, OTD
• Christina Marie Delapp, BCBA
• Makayden Delauder
• Dino A Delaurentis, DO
• Nikkalynn F Delaurentis, DO

• Psychiatric/Mental Health Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.