Individual
MRS. AMANDA KRISTINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 E NORWEGIAN ST, POTTSVILLE, PA 17901-2710
(570) 621-4000
(570) 621-9213
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA058793
PA
363AM0700X
Medical Physician Assistant
Primary
MA058793
PA
Other
Enumeration date
01/22/2017
Last updated
11/26/2019
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