Individual
DR. AMANDA NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1000 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3442
(931) 433-5569
Mailing address
1000 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3442
(931) 433-5569
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
15113
AL
183500000X
Pharmacist
Primary
25622
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4438099
NABP
TN
Enumeration date
12/05/2011
Last updated
12/05/2011
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