Individual
MRS. AMANDA MILLAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CVS DR, WOONSOCKET, RI 02895-6146
(317) 586-1481
Mailing address
20 BLUE LACE DR, WHITELAND, IN 46184-7022
(317) 586-1481
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28231306A
IN
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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