Provider Demographics
NPI:1376322842
Name:GRIFFIN LANDIS, JANA RAYNE (CNM)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:RAYNE
Last Name:GRIFFIN LANDIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 FOXWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-4025
Mailing Address - Country:US
Mailing Address - Phone:865-357-2035
Mailing Address - Fax:
Practice Address - Street 1:300 STONECREST BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6801
Practice Address - Country:US
Practice Address - Phone:629-206-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife