Healthcare Provider Details

I. General information

NPI: 1801453915
Provider Name (Legal Business Name): JAMIE LYNN MARTIN BC-HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 JONES BLVD
MILAN TN
38358-6193
US

IV. Provider business mailing address

1051 JONES BLVD
MILAN TN
38358-6193
US

V. Phone/Fax

Practice location:
  • Phone: 731-388-3669
  • Fax:
Mailing address:
  • Phone: 731-388-3669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number744
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number0000000744
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: