Provider Demographics
NPI:1528554557
Name:BARNEY, JOHANNA RAE (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:RAE
Last Name:BARNEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HANNA
Other - Middle Name:RAE
Other - Last Name:BARNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-0680
Mailing Address - Country:US
Mailing Address - Phone:406-222-0250
Mailing Address - Fax:
Practice Address - Street 1:305 W PARK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-2630
Practice Address - Country:US
Practice Address - Phone:406-222-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOPT-OPT-LIC-3355152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist