Healthcare Provider Details

I. General information

NPI: 1003710120
Provider Name (Legal Business Name): MRS. JENNIFER LYNN BARRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 VOLUNTEER BLVD
KNOXVILLE TN
37996-4515
US

IV. Provider business mailing address

554 DEVON ST
SEYMOUR TN
37865-5616
US

V. Phone/Fax

Practice location:
  • Phone: 865-974-4151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number287878
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: