Individual
JAN LESLIE CREAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
603 LAKE WAY PL, SUITE B, TULLAHOMA, TN 37388-4740
(931) 455-1177
(931) 461-3091
Mailing address
603 LAKE WAY PL, SUITE B, TULLAHOMA, TN 37388-4740
(931) 455-1177
(931) 461-3091
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036135
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4252143
BCBS
TN
Enumeration date
03/21/2006
Last updated
03/23/2010
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