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Individual

AMANDA MOORE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2710 HARNEY ST, STE 100, LARAMIE, WY 82072-0001
(307) 742-9116
Mailing address
2710 HARNEY ST, STE 100, LARAMIE, WY 82072-0001
(307) 771-2884

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
241086
NY
207V00000X
Obstetrics & Gynecology Physician
Primary
MD28544
OR

Other

Enumeration date
04/07/2007
Last updated
03/20/2018
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