MEDICARE: CHRISTIAN C HAYNES CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	901513	MS
2	390200000X	Student in an Organized Health Care Education/Training Program
3	367500000X	Certified Registered Nurse Anesthetist	89140	NM
4	367500000X	Certified Registered Nurse Anesthetist	23269	TN

General Provider Information

NPI Number	:	1740728880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN C HAYNES CRNA

Provider Business Mailing Address
First Line	:	51 HUNTINGTON PL
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-9665
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 EXETER RD.
Second Line	:	SUITE 210
City	:	GERMANTOWN
State	:	TN
Zip	:	38138
Country	:	US
Telephone Number	:	901-818-2160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2017
Last Update Date	:	05/26/2026

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