Provider Demographics
NPI:1215959663
Name:BARNETT, JOANNA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:MARIE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21100 DULLES TOWN CIR STE 297
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2442
Mailing Address - Country:US
Mailing Address - Phone:703-655-1634
Mailing Address - Fax:703-766-1493
Practice Address - Street 1:21100 DULLES TOWN CIR STE 297
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2442
Practice Address - Country:US
Practice Address - Phone:703-421-5333
Practice Address - Fax:703-766-1493
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001133152W00000X
VA0601800277152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190000662Medicare PIN