Provider Demographics
NPI:1598119323
Name:YANEZ, JENESIS M (MD)
Entity type:Individual
Prefix:DR
First Name:JENESIS
Middle Name:M
Last Name:YANEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENESIS
Other - Middle Name:M
Other - Last Name:NEGRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2094 RIVER WATCH DRIVE
Mailing Address - Street 2:
Mailing Address - City:SODDY-DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379
Mailing Address - Country:US
Mailing Address - Phone:305-733-2811
Mailing Address - Fax:
Practice Address - Street 1:1101 CARTER STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-9760
Practice Address - Country:US
Practice Address - Phone:423-490-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000599432080P0006X
TN59943208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics