Individual provider · NPI-1

Kendra Barlow-Johnson

Specialist · Springfield, IL

NPI number1669182705
StatusActive
Last updated in NPPESJul 27, 2025

Details

NPI
1669182705
Entity type
Individual (NPI-1)
Name
Ms. Kendra Barlow-Johnson
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 30, 2022
Certification date
Jul 27, 2025
Last updated
Jul 27, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist––Yes
251E00000X Home Health––
374K00000X Religious Nonmedical Practitioner––
101YP1600X Counselor, Pastoral914078WA
376K00000X Nurse's Aide–IL

Practice location

Po Box 10021
Springfield, IL 62791-0021

Phone 217-843-7692

Mailing address

Po Box 10021
Springfield, IL 62791-0021

Phone 217-843-7692

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