Provider Demographics
NPI:1184929523
Name:RACHELS, JANA (PA)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:RACHELS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:342 FREY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1734
Mailing Address - Country:US
Mailing Address - Phone:615-792-1199
Mailing Address - Fax:615-792-9331
Practice Address - Street 1:342 FREY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1734
Practice Address - Country:US
Practice Address - Phone:615-792-1199
Practice Address - Fax:615-792-9331
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02666363A00000X
TN2694363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5458976OtherBCBST
TNP01574531OtherRR MEDICARE
TNQ016403Medicaid
TNQ016403Medicaid