Healthcare Provider Details

I. General information

NPI: 1346324894
Provider Name (Legal Business Name): JANE ANN BARTON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 E BROADWAY AVE
MARYVILLE TN
37804-4155
US

IV. Provider business mailing address

1317 E BROADWAY AVE
MARYVILLE TN
37804-4155
US

V. Phone/Fax

Practice location:
  • Phone: 865-804-5329
  • Fax:
Mailing address:
  • Phone: 865-804-5329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2456
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: