Individual
AMANDA JOHNSTUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
645 SHIPLEY AVE, GROVETOWN, GA 30813-4249
(706) 836-8161
Mailing address
645 SHIPLEY AVE, GROVETOWN, GA 30813-4249
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN-CRNA209314
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN209314
GA
Other
Enumeration date
12/22/2015
Last updated
03/06/2026
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