Provider Demographics
NPI:1831872514
Name:HAEFELE, JAMESLYNN WAYNE
Entity type:Individual
Prefix:
First Name:JAMESLYNN
Middle Name:WAYNE
Last Name:HAEFELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 PRYOR DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-5062
Mailing Address - Country:US
Mailing Address - Phone:615-574-9645
Mailing Address - Fax:
Practice Address - Street 1:5205 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2592
Practice Address - Country:US
Practice Address - Phone:615-857-3076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2025-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003583111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner