Individual
AMANDA C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
611 ALCORN DR, CORINTH, MS 38834-9368
(662) 293-1440
(662) 293-4334
Mailing address
611 ALCORN DR, CORINTH, MS 38834-9368
(662) 293-1440
(662) 293-4334
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R864380
MS
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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