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Individual

AMANDA NICOLE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
STNA

Contact information

Practice address
5831 RAVENNA AVE, LOUISVILLE, OH 44641-9216
(330) 581-5099
Mailing address
116 EUCLID AVE, MINERVA, OH 44657-1519
(330) 904-8124

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
401158021010
OH

Other

Enumeration date
07/24/2017
Last updated
07/24/2017
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