Individual
KELLY S. BARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 434-7088
(260) 435-7394
Mailing address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 434-7088
(260) 435-7394
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004094A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201086860
—
IN
Enumeration date
05/15/2012
Last updated
03/19/2013
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