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General NPI Number Information
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NPI Number | 1669182705
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Entity Type | Individual
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Provider Name | MS. KENDRA BARLOW-JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 07/27/2025
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Provider Practice Location Address
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Address Line | PO BOX 10021
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City | SPRINGFIELD
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State | IL
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Zip | 62791-0021
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Country | US
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Telephone | 217-843-7692
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10021
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City | SPRINGFIELD
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State | IL
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Zip | 62791-0021
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Country | US
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Telephone | 217-843-7692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 914078
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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