Individual
TYLER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2628 E GLENWOOD ST, SPRINGFIELD, MO 65804-3422
(417) 860-8465
Mailing address
2628 E GLENWOOD ST, SPRINGFIELD, MO 65804-3422
(417) 860-8465
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
2016015074
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277003758
FULL PRACTICE AUTHORITY APRN
IL
Enumeration date
06/03/2016
Last updated
11/20/2025
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