Individual
AMANDA F JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7990 ARCO CORPORATE DR STE 110, RALEIGH, NC 27617-2030
(919) 544-5900
(919) 488-1455
Mailing address
260 HORIZON DR, RALEIGH, NC 27615-4922
(919) 488-0015
(919) 277-0066
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
158854
NC
363L00000X
Nurse Practitioner
158854
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
158854
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158854
NURSING LICENSE
NC
05
—
7004606
—
NC
Enumeration date
04/17/2007
Last updated
09/26/2013
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