Individual
MRS. AMANDA LORGE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3990 FETTLER PARK DR, DUMFRIES, VA 22025-1997
(571) 499-5813
Mailing address
4565 DAISY REID AVE, WOODBRIDGE, VA 22192-5670
(571) 297-1414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024175961
VA
363LF0000X
Family Nurse Practitioner
11045707
FL
363LF0000X
Family Nurse Practitioner
RN1045832
DC
Other
Enumeration date
08/03/2017
Last updated
04/28/2026
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