Individual
AMANDA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27101
(336) 716-6701
Mailing address
3711 BENCHLEY RD, WINSTON SALEM, NC 27106-4707
(912) 424-9944
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
289837
NC
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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