Healthcare Provider Details

I. General information

NPI: 1437142890
Provider Name (Legal Business Name): ALECIA LANE BARNES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 LOWER SHILOH WAY
MORRISVILLE NC
27560-5430
US

IV. Provider business mailing address

1004 LOWER SHILOH WAY
MORRISVILLE NC
27560-5430
US

V. Phone/Fax

Practice location:
  • Phone: 919-472-4070
  • Fax: 919-472-4069
Mailing address:
  • Phone: 919-472-4070
  • Fax: 919-472-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1644
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1644
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: