Provider Demographics
NPI:1063407773
Name:DREYZEHNER, JANA K (MD)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:K
Last Name:DREYZEHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CHURCH ST
Mailing Address - Street 2:#2802
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2308
Mailing Address - Country:US
Mailing Address - Phone:276-356-5262
Mailing Address - Fax:615-523-1589
Practice Address - Street 1:312 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228-6786
Practice Address - Country:US
Practice Address - Phone:276-356-5262
Practice Address - Fax:615-523-1589
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010559152084P0800X
TNMD00000293942084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA260041732OtherMEDICARE RAILROAD
VA004945522Medicaid
VA326864OtherBCBS
VA326864OtherBCBS
VA007703C65Medicare PIN