Individual provider Active NPI

Marilyn D Haymaker, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hendersonville, TN
National Provider Identifier
1669720587
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN0000023259 Issued in TN
Practice address
145 Devonshire TRL
Hendersonville, TN 37075-5812
Phone
(615) 813-4672
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
91619TNMDRegistered Nurse
APN0000023259TNMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 91619 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN0000023259 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

145 Devonshire TRL
Hendersonville, TN 37075-5812

Mailing address

145 Devonshire TRL
Hendersonville, TN 37075-5812
Phone (615) 400-3608

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2023.

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1669720587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 DEVONSHIRE TRL",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370755812",
            "telephone_number": "615-400-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 DEVONSHIRE TRL",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370755812",
            "telephone_number": "615-813-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYMAKER",
        "first_name": "MARILYN",
        "middle_name": "D",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2023-07-10",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "91619",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN0000023259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.