Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 3144 | TN |
Y | 208000000X | Pediatrician | 3144 | TN |
NPI | 1396006649 |
---|---|
Provider Name | Dr. Jessica Marie Barnes |
First Address | Memphis, TN 38103-2800 |
Second Address | Memphis, TN 38103-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2012 |
Last Update Date | 21/11/2016 |