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Individual

MRS. AMBER WALLACE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-3000
Mailing address
1040 LINN ST, CHINA GROVE, NC 28023-5784
(704) 222-8763

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
274810
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
6796
NC

Other

Enumeration date
07/13/2021
Last updated
01/02/2022
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