Healthcare Provider Details

I. General information

NPI: 1477724342
Provider Name (Legal Business Name): JEANNE ELLEN BARNO MA-CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 LIGHTHOUSE MANOR DRIVE
GAINESVILLE GA
30501-7401
US

IV. Provider business mailing address

4380 GEORGETOWN SQ STE 1002
ATLANTA GA
30338-6254
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-4352
  • Fax: 770-532-8165
Mailing address:
  • Phone: 770-220-8408
  • Fax: 770-234-9979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD003746
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: