Individual
AMANDA NYCOL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5703 LACHMAN AVE NE, ALBERTVILLE, MN 55301-3973
(763) 284-1877
(763) 205-5834
Mailing address
1772 STIEGER LAKE LN STE 220, VICTORIA, MN 55386-7720
(952) 443-4600
(952) 443-4604
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8495
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
8495
MN
Other
Enumeration date
09/07/2021
Last updated
10/06/2025
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