Provider Demographics
NPI:1952286221
Name:HAILE, JEAN EVELYN
Entity type:Individual
Prefix:MISS
First Name:JEAN
Middle Name:EVELYN
Last Name:HAILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVIE
Other - Middle Name:
Other - Last Name:HAILE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:585 NASHVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3123
Mailing Address - Country:US
Mailing Address - Phone:615-451-4139
Mailing Address - Fax:
Practice Address - Street 1:585 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3123
Practice Address - Country:US
Practice Address - Phone:615-451-4139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000067476183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician