Healthcare Provider Details

I. General information

NPI: 1912212879
Provider Name (Legal Business Name): SCARLETT MARIE MYNATT APN FNP PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1066 RUTLEDGE PIKE
BLAINE TN
37709-3027
US

IV. Provider business mailing address

315 WHITE OAK DR
SEYMOUR TN
37865-5128
US

V. Phone/Fax

Practice location:
  • Phone: 865-465-3310
  • Fax: 865-465-3307
Mailing address:
  • Phone:
  • Fax: 865-281-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15560
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number145791
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number15560
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: