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Individual

ROGER DALE BARNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP

Contact information

Practice address
2946 WINFIELD DUNN PARKWAY, SUITE 107, KODAK, TN 37764
(865) 933-9950
(865) 465-3937
Mailing address
2946 WINFIELD DUNN PKWY STE 107, KODAK, TN 37764-4316
(865) 933-9950

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
APN
TN
363L00000X
Nurse Practitioner
Primary
APN0000013355
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1526565
TN
Enumeration date
03/24/2008
Last updated
06/09/2015
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