Provider Demographics
NPI:1609834845
Name:CRIM, JANA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:LYNN
Last Name:CRIM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MOSS LN STE 110
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1455
Mailing Address - Country:US
Mailing Address - Phone:615-905-8190
Mailing Address - Fax:615-905-8938
Practice Address - Street 1:40 MOSS LN STE 110
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1455
Practice Address - Country:US
Practice Address - Phone:615-905-8190
Practice Address - Fax:615-905-8938
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1886152W00000X
ALSA27TA592152W00000X
TN2332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89093NVMedicaid
NC093NVOtherBLUECROSS BLUE SHIELD
NC89093NVMedicaid
NC2472984Medicare ID - Type UnspecifiedMEDICARE