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Individual

AMANDA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
232 S WOODS MILL RD, CHESTERFIELD, MO 63017-3485
(314) 434-1500
Mailing address
1065 TIMBERLINE DR, FENTON, MO 63026-4557

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2024013896
MO

Other

Enumeration date
10/30/2024
Last updated
10/30/2024
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