Provider Demographics
NPI:1972281384
Name:J&J MEDICAL PLLC
Entity type:Organization
Organization Name:J&J MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:865-774-7481
Mailing Address - Street 1:208 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-3821
Mailing Address - Country:US
Mailing Address - Phone:865-774-7481
Mailing Address - Fax:865-908-2455
Practice Address - Street 1:208 PRINCE ST
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3821
Practice Address - Country:US
Practice Address - Phone:865-774-7481
Practice Address - Fax:865-908-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty