Provider Demographics
NPI:1801453915
Name:MARTIN, JAMIE LYNN (BC-HIS)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-6193
Mailing Address - Country:US
Mailing Address - Phone:731-388-3669
Mailing Address - Fax:
Practice Address - Street 1:1051 JONES BLVD
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-6193
Practice Address - Country:US
Practice Address - Phone:731-388-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000744237700000X
TN744332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist