MS. Jana Brielle Lack, PA-C
NPI #1790425080 in Crossville, Tennessee
Provider Information
- NPI Number
- 1790425080
- Entity Type
- Individual
- Name
- MS. Jana Brielle Lack, PA-C
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Apr 1, 2022
- Last Updated
- Oct 19, 2022
Practice Location
- Address
- 118 BROWN AVE STE 103
- City
- Crossville
- State
- Tennessee
- ZIP Code
- 38555-7740
- Phone
- (931) 484-8861
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Physician Assistant |
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