Healthcare Provider Details

I. General information

NPI: 1649136185
Provider Name (Legal Business Name): TARRENCE BARLOW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6912 LAKE ST
OMAHA NE
68104-3833
US

IV. Provider business mailing address

1401 E GOLD COAST RD STE 430
PAPILLION NE
68046-5748
US

V. Phone/Fax

Practice location:
  • Phone: 402-983-5553
  • Fax:
Mailing address:
  • Phone: 402-331-3073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: