Kindred Johnson, Amy L

Kindred Johnson, Amy L is an individual health care provider with primary practice located at 415 N 9Th St , Springfield IL 62702-5303. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Kindred Johnson, Amy L can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
415 N 9Th St Springfield IL 62702-5303
Phone: (217) 545-8000
Fax: (217) 757-6844
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209-003537 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 277000915 Illinois

Profile Details

NPI number 1407055353
LBN Legal business name Kindred Johnson, Amy L
Credentials CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2007
Last updated Aug 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407055353 NPPES
Illinois Other 209-003537 STATE LICENSE

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