Provider Demographics
NPI:1194947259
Name:BYRNE, JENNIE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:
Last Name:BYRNE
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:JENNIE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:643 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6714
Mailing Address - Country:US
Mailing Address - Phone:919-428-5154
Mailing Address - Fax:919-910-5488
Practice Address - Street 1:643 ROCK CREEK RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6714
Practice Address - Country:US
Practice Address - Phone:919-428-5154
Practice Address - Fax:919-910-5488
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145081261QM0850X, 103TP0016X
TN596542084P0800X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)