Individual
MRS. AMANDA JANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
705 NEWMAN RD, NEW BERN, NC 28562-5239
(252) 633-2712
Mailing address
705 NEWMAN RD, NEW BERN, NC 28562-5239
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
103524
NC
363AS0400X
Surgical Physician Assistant
Primary
103524
NC
Other
Enumeration date
09/19/2006
Last updated
12/03/2008
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