Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Jana Brielle Lack, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790425080

MS. Jana Brielle Lack, PA-C is a Physician Assistant in Crossville, Tennessee. Qualified in 2022, 4 years ago. Practices with Covenant Medical Group Inc, a 356-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Crossville, TN
Fax: (865) 374-2116

No coordinates on file. Search this address in Google Maps

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790425080
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedApril 1, 2022
Last updated in NPPESOctober 19, 2022
Certification dateOctober 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Covenant Medical Group Inc — 356 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Crossville