Healthcare Provider Details

I. General information

NPI: 1588851976
Provider Name (Legal Business Name): KRISTI MICHELLE BARNES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRIST MICHELLE JOHNSON O.D.

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 HIGHWAY 92 S STE 7
DANDRIDGE TN
37725-4578
US

IV. Provider business mailing address

334 HIGHWAY 92 S STE 7
DANDRIDGE TN
37725-4578
US

V. Phone/Fax

Practice location:
  • Phone: 865-397-9991
  • Fax: 865-940-1401
Mailing address:
  • Phone: 865-397-9991
  • Fax: 865-940-1401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1721DT
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2771
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: