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Individual

MRS. AMANDA BRADLEY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
11491 US 70 HWY W, CLAYTON, NC 27520-2207
(919) 550-2484
Mailing address
1328 W ST SE, WASHINGTON, DC 20020-5718
(202) 610-7160
(202) 610-7164

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5012876
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024905300
DC
Enumeration date
03/06/2012
Last updated
02/02/2022
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